Racial Inequity in Prescription of Semaglutide Among Eligible People With HIV
Bibliographic record
Abstract
OBJECTIVE: To evaluate semaglutide use among people with HIV (PWH) with medical indications by race and ethnicity. RESEARCH DESIGN AND METHODS: We identified PWH in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort at nine sites eligible for semaglutide therapy between 2019 and 2023. Semaglutide eligibility was based on BMI ≥30 or HbA1c ≥6.5. We evaluated differences in semaglutide receipt among eligible PWH by race and ethnicity using relative risk regression adjusted for demographic characteristics. RESULTS: Among 11,617 eligible PWH, 774 (6.7%) received semaglutide (92% eligible by BMI ≥30, 62% by HbA1c ≥6.5, and 54% by both criteria). Eligible Black PWH were 20% less likely to receive semaglutide versus White PWH (prevalence ratio [PR] 0.80, 95% CI 0.67-0.95). The lower rate of semaglutide for Black (PR 0.66, 95% CI 0.53-0.83) and Hispanic PWH (PR 0.70, 95% CI 0.53-0.93) was more pronounced among those with higher HbA1c (≥8.0). CONCLUSIONS: We describe inequitable semaglutide use among PWH, with lower initiation rates in eligible Black PWH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".