Delayed Diagnosis of HIV among Non-Latino Black Caribbean Immigrants in Florida 2000-2014 (original) (raw)

Individual and Neighborhood Determinants of Late HIV Diagnosis Among Latinos, Florida, 2007–2011

Journal of Immigrant and Minority Health, 2016

The objective of this study was to examine individual and neighborhood determinants of late HIV diagnosis by gender and birthplace among Latinos. Florida HIV surveillance data for 2007-2011 were merged with American Community Survey data to estimate the odds of late HIV diagnosis (AIDS within 3 months of HIV diagnosis). Of 5522 HIV-positive Latinos, 26.5 % were diagnosed late. The odds ratio (OR) for late diagnosis was 1.39 times higher for males than females [95 % confidence interval (CI) 1.14-1.69]. Neighborhood-level factors associated with late diagnosis included residing in the 3 highest quartiles of neighborhood unemployment for males. The OR was 1.22 times higher for foreign-than US-born Latinos (95 % CI 1.07-1.40). Among foreignborn, residing in areas in the 2nd and 3rd quartiles of unemployment, in rural areas, and areas with

Ethnic Differences in HIV Risk Perceptions and Behaviors Among Black 18–39 Year-Old Residents of Broward County, Florida

AIDS Education and Prevention, 2010

The study assessed ethnic differences in the perceived risks of HIV infection, sexual experiences, and HIV-antibody testing histories among Black populations in Broward County, Florida. Data were analyzed for 2,731 well-characterized survey respondents 18-39 years old who indicated they were African Americans, Caribbean Islanders, English-speaking, or Creole-speaking Haitians. Creole-speaking Haitians were least likely to consider themselves at risk of HIV infection, report using condoms in the last 12 months, and indicate that they had ever been tested for HIV. English-speaking Haitians were more likely than African Americans to report never engaging in sexual intercourse and were less likely to have ever been tested for HIV. Englishspeaking Caribbean Islanders reported preventive behaviors similar to those of African Americans, but had lower perceptions of HIV risk and were less likely to have ever been tested. Health promotion programs designed to improve HIV prevention practices must appreciate social and cultural differences among Black populations.

Disparity in Retention in Care and Viral Suppression for Black Caribbean-Born Immigrants Living with HIV in Florida

International journal of environmental research and public health, 2017

(1) The study aim was to assess disparities in non-retention in HIV care and non-viral suppression among non-Hispanic Black Caribbean immigrants living with HIV in Florida. (2) We analyzed cases involving individuals, aged ≥13, who met CDC HIV case definition during 2000-2014. Chi square test was used to evaluate differences in non-retention and non-viral suppression by country of origin/race/ethnicity. Multilevel logistic regressions with three referent groups [US-born Blacks, Hispanics, and non-Hispanic Whites (NHWs)] were used to estimate adjusted odds ratios (aOR). (3) Caribbean-born Blacks were less likely to be retained in care or be virally suppressed than US-born Blacks, Hispanics, and NHWs. Bahamians, Haitians, and Trinidadians and Tobagonians had increased odds of non-retention (aOR 3.13, 95% confidence interval [

Social Determinants of Late Stage HIV Diagnosis and its Distributions among African Americans and Latinos: A critical literature review

Journal of health disparities research and practice, 2014

This critical literature review was conducted to identify both individualand environmentallevel social determinants of health using an ecological framework as a way to contextualize risk for, and distributions of, late HIV diagnosis among African Americans and Latinos in the United States. Background: Late diagnosis, defined as a diagnosis of AIDS simultaneously with or within one year of an initial HIV diagnosis,1 disproportionately affects African American and Latino communities;2,3 disparities in this health problem thus represent a preventable inequity. Such disparities affect not only late diagnosed individuals but also population levels of HIV incidence, as transmission is unhindered before diagnosis.4,5 Methods: A total of 26 unduplicated studies in 26 peer-reviewed articles were analyzed within a social ecological conceptual framework. Both quantitative and qualitative studies of factors influencing HIV testing were reviewed. To be included, studies had to have been conducte...

Differences in HIV-Related Hospitalization Trends Between Haitian-Born Blacks and US-Born Blacks

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2007

Objectives: To examine the HIV care needs and hospital admission patterns of HIV-positive Haitian-born blacks (Haitians) and compare them with those of US-born blacks (Blacks). Methods: We abstracted the medical records of 635 Blacks and Haitians consecutively admitted to the adult HIV Service at Jackson Memorial Hospital during 2004 for information on demographics, use of antiretroviral therapy, CD4 cell counts, primary and secondary diagnoses at admission, and substance use. The probability of being prescribed highly active antiretroviral therapy (HAART) was examined by country of origin. Results: There was no statistically significant difference between the groups in likelihood to be prescribed HAART. In controlled analyses, however, Haitians were 76% more likely than Blacks to have a CD4 count ,51 cells/mm 3 and tended to be more recently diagnosed with HIV. Moreover, tuberculosis was the most prevalent opportunistic infection for Haitians compared with candidiasis for Blacks. Conclusions: Findings suggest that barriers to medical care may exist for Haitians at an early stage of the access continuum and that prevention efforts among the Haitian HIV-positive population should be directed at promoting the need for timely use of health services.

HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016

International Journal of Environmental Research and Public Health, 2018

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African-and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.

Differences Between U.S.-Born and Non-U.S.-Born Black Adults Reported with Diagnosed HIV Infection: United States, 2008-2014

Journal of immigrant and minority health, 2018

Despite improvements in its treatment, HIV infection continues to affect Blacks disproportionally. Using National HIV Surveillance System data from 50 U.S. states and the District of Columbia, we examined demographic and epidemiologic differences between U.S.-born and non-U.S.-born Black adults. Of 110,452 Black adults reported with diagnosed HIV during 2008-2014 with complete country of birth information, 11.1% were non-U.S.-born. Non-U.S.-born were more likely to be older, female, have HIV infection attributed to heterosexual contact, have been diagnosed late, and live in the northeastern U.S. region. During 2014, the HIV diagnosis rate among African-born Black females was 1.4 times the rate of U.S.-born Black males, 2 times the rate of African-born Black males, and 5.3 times the rate of U.S.-born Black females. We elucidate the differences between U.S.-born and non-U.S.-born Blacks on which to base culturally appropriate HIV-prevention programs and policies.

The AIDS epidemic in south Florida: black non-Hispanics in our communities remain increasingly vulnerable

We compared demographic variables of individuals in Miami-Dade County, Florida, USA, with Acquired Immune Deficiency Syndrome (AIDS) during two time periods (1993-1995 and 2009-2011). Incidence and mortality-related data were explored in this observational study. Tests of significance were performed to identify differences or associations between selected groups. A correlation analysis was conducted to identify relationships between AIDS diagnosis and socioeconomic indicators. We observed a reduction in the number of new AIDS cases reported and AIDS-related mortality. Nonetheless, AIDS is still disproportionately affecting the black non-Hispanic population. Black non-Hispanic women remain particularly vulnerable to the disease. A positive correlation between AIDS diagnosis and poverty rate and the lack of health insurance, and a negative correlation between AIDS diagnosis and education level were identified. Though the actual number of AIDS cases is declining in this region, it continues to disproportionately affect the poorer, less well

Black-White and Country of Birth Disparities in Retention in HIV Care and Viral Suppression among Latinos with HIV in Florida, 2015

International journal of environmental research and public health, 2017

The study's purpose was to identify HIV, Black-White race, and birth country disparities in retention in HIV care and HIV viral load (VL) suppression among Latinos, in 2015. Florida's surveillance data for Latinos diagnosed with HIV (2000-2014) were merged with American Community Survey data. Multi-level (random effects) models were used to estimate adjusted odds ratios (aOR) for non-retention in care and non-viral load suppression. Blacks and Whites experienced similar odds of non-retention in care. Racial differences in VL suppression disappeared after controlling for neighborhood factors. Compared to U.S.-born Latinos, those born in Mexico (retention aOR 2.00, 95% CI 1.70-2.36; VL 1.85, 95% CI 1.57-2.17) and Central America (retention aOR 1.33, 95% CI 1.16-1.53; VL 1.28, 95% CI 1.12-2.47) were at an increased risk after controlling for individual and neighborhood factors. Among Central Americans, those born in Guatemala (retention aOR 2.39, 95% CI 1.80-3.18; VL 2.20, 95% ...