FIU professor receives grant to study racial disparities in AIDS survival

Mary Jo Trepka, M.D., associate professor in the Department of Epidemiology and Biostatistics at the Robert Stempel College of Public Health and Social Work, has received a $1.3 million grant for a unique five-year study that will focus on racial disparities in AIDS survival in Florida.

African-Americans in the United States have been disproportionately affected by HIV/AIDS since the epidemic’s beginning, and that disparity has deepened over time.

Although highly interactive antiretroviral therapy has been widely available for more than 10 years, only 79 percent  of African-Americans who contract HIV/AIDS live beyond three years. In contrast, 85 percent of Hispanics and 84 percent of non-Hispanic whites afflicted with the illness survive beyond that time.

This health crisis is particularly acute in Miami-Dade, Broward and Palm Beach Counties, which have the highest AIDS rate in the United States; the State of Florida is fourth in the country.

Trepka’s research, funded by the National Institutes of Health’s National Center on Minority Health and Health Disparities (NCMHD), will examine the reasons for the differences by studying Florida residents who were afflicted with AIDS from 1993 to 2007.

It will be the first population-based study of racial disparities in AIDS survival to evaluate the impact of race at a statewide level and examine the role of segregation, rural-urban residence and community deprivation. Socioeconomic status will be examined in a relatively complex manner using wealth, poverty, income, education and occupation. The study will also focus on how socioeconomic status, segregation and residence change between AIDS diagnosis and death.

“We want to explain why there is such a significant difference in the survival rates of individuals who contract AIDS,” Trepka said. “Which factors are playing a role in causing that disparity? To what extent do socioeconomic status and access to health care contribute to the disparities?”

Surveillance records from the Florida Department of Health HIV/AIDS Reporting System will be matched with Florida Vital Records, Social Security Death Index and National Death Index records to determine survival status.

Trepka’s study reinforces FIU’s mission to help eliminate health disparities and improve community health. It will also support two FIU doctoral students as research assistants for five years and provide data for Ph.D. students’ dissertations.

“There isn’t going to be an easy fix to this problem,” Trepka said. “But we hope to contribute to the knowledge of why these racial disparities in AIDS survival exist.”

“Hopefully, the study will lead to policy changes that might solve some fundamental problems, such as access to health care and social and economic disparities,” Trepka added. “It could lay the groundwork for guiding intervention studies and affecting policy changes that improve the rate of AIDS survival among African-Americans.”