1/ What do #racism & #redlining have to do with inequities in #HIV outcomes?
Our new study just published in #ClinInfectDis examines neighborhood deprivation, race/ethnicity, and HIV viral suppression. Thread 👇🏾
#MedTwitter #MedStudentTwitter #IDTwitter
doi.org/10.1093/cid/ci…
Our new study just published in #ClinInfectDis examines neighborhood deprivation, race/ethnicity, and HIV viral suppression. Thread 👇🏾
#MedTwitter #MedStudentTwitter #IDTwitter
doi.org/10.1093/cid/ci…
2/ #Redlining in the 1930s involved racialized federal mapping of housing "desirability" (L) --> ⬆️💰 into White/affluent areas + systematic disinvestment in "undesirable" areas.
To this day, HOLC maps of urban areas like Omaha STILL align w/deprivation & racial segregation (R).
To this day, HOLC maps of urban areas like Omaha STILL align w/deprivation & racial segregation (R).
3/ Omaha is among the most segregated U.S. cities. Our HIV clinic serves ~50% Black and Latinx pts, who disproportionately live in deprived neighborhoods.
We assessed neighborhood disadvantage using the ADI, outlined by @amyjhkind et al. in @NEJM.
nejm.org/doi/full/10.10…
We assessed neighborhood disadvantage using the ADI, outlined by @amyjhkind et al. in @NEJM.
nejm.org/doi/full/10.10…
4/ Our analysis found:
✅Viral suppression rates among Black ppl w/HIV (PWH) < White PWH
✅Black-White differences were non-significant after adjusting for age, sex, income, ADI, rurality
✅ADI & poverty independently & inversely assoc. w/suppression
doi.org/10.1093/cid/ci…
✅Viral suppression rates among Black ppl w/HIV (PWH) < White PWH
✅Black-White differences were non-significant after adjusting for age, sex, income, ADI, rurality
✅ADI & poverty independently & inversely assoc. w/suppression
doi.org/10.1093/cid/ci…
5/ Why does this matter?
As we aim to #EndHIVEpidemic, we need to think beyond the clinic walls. The *structural* -isms require *structural* interventions.
The phenomenal Invited Commentary by Doshi et al. expands on our brief discussion section 👇🏾
doi.org/10.1093/cid/ci…
As we aim to #EndHIVEpidemic, we need to think beyond the clinic walls. The *structural* -isms require *structural* interventions.
The phenomenal Invited Commentary by Doshi et al. expands on our brief discussion section 👇🏾
doi.org/10.1093/cid/ci…
6/ Building #structuralcompetency in #MedEd (h/t @JonathanMetzl & Helena Hanson) is critical to understanding sociopolitical drivers of inequity like #redlining.
At @UNMC, @DrJRMarcelin and I partner with our community to start these conversations early.
At @UNMC, @DrJRMarcelin and I partner with our community to start these conversations early.
7/ #HIV advocacy must similarly center structural interventions, including broad suggestions from Doshi et al:
✅Changes in welfare policy
✅Integrated models of care
✅Comprehensive sex education
✅Harm reduction programs
✅Protecting the rights of sexual/gender minorities
✅Changes in welfare policy
✅Integrated models of care
✅Comprehensive sex education
✅Harm reduction programs
✅Protecting the rights of sexual/gender minorities
8/ In sum: To reduce HIV inequities, we need to dismantle -isms & intervene upon systemic (> individual) drivers.
Gratitude to @shurtadobares @DrJRMarcelin, truly incredible research (and life! ☺️) mentors, and to our @UNMC_ID clinic team & patients!
doi.org/10.1093/cid/ci…
Gratitude to @shurtadobares @DrJRMarcelin, truly incredible research (and life! ☺️) mentors, and to our @UNMC_ID clinic team & patients!
doi.org/10.1093/cid/ci…
