Sex, Race, and Geographic Region Influence Clinical Outcomes Following Primary HIV-1 Infection

BACKGROUND: It is unknown whether sex and race influence clinical outcomes following primary human immunodeficiency virus type 1 (HIV-1) infection. METHODS: Data were evaluated from an observational, multicenter, primarily North American cohort of HIV-1 seroconverters. RESULTS: Of 2277 seroconverters, 5.4% were women. At enrollment, women averaged .40 log₁₀ fewer copies/mL of HIV-1 RNA (P .73). Women were 2.17-fold more likely than men to experience >1 HIV/AIDS-related event (P 1 HIV/AIDS-related event had occurred in 78% of nonwhites and 37% of whites from the southern United States, and 24% of whites and 17% of nonwhites from other regions (P < .001). CONCLUSIONS: Despite more favorable clinical parameters initially, female HIV-1-seroconverters had worse outcomes than did male seroconverters. Elevated morbidity was associated with being nonwhite and residing in the southern United States.