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Kathleen A. McGinnis, MS, Michael J. Fine, MD, MSc, Ravi K. Sharma, PhD, Melissa Skanderson, MSW, Joseph H. Wagner, MPH, Maria C. Rodriguez-Barradas, MD, Linda Rabeneck, MD, MPH and Amy C. Justice, MD, PhD

Kathleen A. McGinnis, Melissa Skanderson, Joseph H. Wagner, and Amy C. Justice are with the Veterans Aging Cohort Study Center, VA Pittsburgh Healthcare System, Pittsburgh, Pa. Kathleen A. McGinnis, Michael J. Fine is with, and, Melissa Skanderson, Joseph H. Wagner, and Amy C. Justice are also with, the Center for Health Equity Research and Promotion, Pittsburgh. Michael J. Fine and Amy C. Justice are also with the University of Pittsburgh Center for Research on Health Care, School of Medicine, Division of General Internal Medicine, Pittsburgh. Ravi K. Sharma is with the University of Pittsburgh Graduate School of Public Health, Pittsburgh. Maria C. Rodriguez-Barradas and Linda Rabeneck are with the VA Health Services Research and Development Center of Excellence, VA Medical Center, Houston, Tex. Linda Rabeneck is also with the Department of Medicine, Baylor College of Medicine and the VA Medical Center, Houston, Tex.

Correspondence: Requests for reprints should be sent to Amy C. Justice, MD, PhD, West Haven VA Healthcare System, 950 Campbell Ave, 11-ACSLG, West Haven, CT 06516.

Objectives. We identified race-associated differences in survival among HIV-positive US veterans to examine possible etiologies for these differences.

Methods. We used national administrative data to compare survival by race and used data from the Veterans Aging Cohort 3-Site Study (VACS 3) to compare patients’ health status, clinical management, and adherence to medication by race.

Results. Nationally, minority veterans had higher mortality rates than did white veterans with HIV. Minority veterans had poorer health than white veterans with HIV. No significant differences were found in clinical management or adherence.

Conclusions. HIV-positive minority veterans experience poorer survival than white veterans. This difference may derive from differences in comorbidities and in the severity of illness of HIV-related disease.

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