Black–White and Country of Birth Disparities in Retention in HIV Care and Viral Suppression among Latinos with HIV in Florida, 2015
Abstract
:1. Introduction
2. Data and Methods
2.1. Datasets
2.2. Individual-Level Variables
2.3. Neighborhood-Level Variables
2.4. Statistical Analyses
3. Results
3.1. Characteristics of Participants
3.2. Retention in HIV Care
3.3. Viral Suppression
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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All Latinos a | United States-Born Latinos | Puerto Rico | Mexico | Cuba | Central America b | South America c | |
---|---|---|---|---|---|---|---|
Total (n) | 12,106 | 4276 | 1153 | 842 | 2618 | 1284 | 1933 |
Individual-Level Variables | |||||||
Year of HIV diagnosis | |||||||
2000–2003 | 3007 (24.8) | 954 (22.3) | 341 (29.6) | 254 (30.2) | 527 (20.1) | 309 (24.1) | 622 (32.2) |
2004–2007 | 3291 (27.2) | 1204 (28.2) | 286 (24.8) | 266 (31.6) | 605 (23.1) | 408 (31.8) | 522 (27.0) |
2008–2011 | 3158 (26.1) | 1233 (28.8) | 290 (25.2) | 189 (22.5) | 679 (25.9) | 354 (27.6) | 413 (21.4) |
2012–2014 | 2650 (21.9) | 885 (20.7) | 238 (20.5) | 133 (15.8) | 807 (30.8) | 213 (16.6) | 376 (19.5) |
Race d | |||||||
Black | 740 (6.1) | 416 (9.7) | 76 (6.6) | 12 (1.4) | 118 (4.5) | 80 (6.1) | 38 (2.0) |
White | 11,366 (93.9) | 3860 (90.3) | 1077 (93.4) | 830 (98.6) | 2500 (95.5) | 1204 (93.8) | 1895 (98.0) |
Sex at birth | |||||||
Male | 9997 (82.6) | 3352 (78.4) | 878 (76.2) | 727 (86.3) | 2388 (91.2) | 983 (76.6) | 1669 (86.3) |
Female | 2109 (17.4) | 924 (21.6) | 275 (23.9) | 115 (13.7) | 230 (8.8) | 301 (23.4) | 264 (13.7) |
Age at diagnosis | |||||||
13–24 | 1630 (13.5) | 865 (20.2) | 125 (10.8) | 125 (14.9) | 205 (7.8) | 157 (12.2) | 153 (7.9) |
25–49 | 8969 (74.1) | 3023 (70.7) | 840 (72.9) | 648 (77.0) | 1884 (72.0) | 1010 (78.7) | 1564 (80.9) |
50 or older | 1507 (12.5) | 388 (9.1) | 188 (16.3) | 69 (8.2) | 529 (20.2) | 117 (9.1) | 216 (11.2) |
Mode of transmission | |||||||
IDU | 860 (7.1) | 392 (9.2) | 233 (20.2) | 41 (4.9) | 89 (3.4) | 44 (3.4) | 61 (3.2) |
MSM | 7434 (61.4) | 2506 (58.6) | 526 (45.6) | 413 (49.1) | 1983 (75.7) | 630 (49.1) | 1376 (71.2) |
Heterosexual | 2901 (24.0) | 1026 (24.0) | 304 (26.4) | 266 (31.6) | 438 (16.7) | 483 (37.6) | 384 (19.9) |
Other | |||||||
unknown | 911 (7.5) | 352 (8.2) | 90 (7.8) | 122 (14.5) | 108 (4.1) | 127 (9.9) | 112 (5.8) |
AIDS | |||||||
No | 6906 (57.1) | 2527 (59.1) | 640 (55.5) | 370 (43.9) | 1633 (62.4) | 586 (45.6) | 1150 (59.5) |
Yes | 5200 (43.0) | 1749 (40.9) | 513 (44.5) | 472 (56.1) | 985 (37.6) | 698 (54.4) | 783 (40.5) |
ZCTA-Level Variables | |||||||
SES index, quartiles | |||||||
1 (lowest) | 4786 (39.5) | 1532 (35.8) | 424 (36.8) | 414 (49.2) | 1214 (46.4) | 688 (53.6) | 514 (26.6) |
2 | 2825 (23.3) | 1048 (24.5) | 324 (28.1) | 191 (22.7) | 574 (21.9) | 238 (18.5) | 450 (23.3) |
3 | 3001 (24.8) | 1094 (25.6) | 265 (23.0) | 161 (19.1) | 625 (23.9) | 240 (18.7) | 616 (31.9) |
4 (highest) | 1494 (12.3) | 602 (14.1) | 140 (12.1) | 76 (9.0) | 205 (7.8) | 118 (9.2) | 353 (18.3) |
RUCA Classification | |||||||
Urban | 11,870 (98.1) | 4180 (97.8) | 1123 (97.4) | 785 (93.2) | 2596 (99.2) | 1279 (99.2) | 1922 (99.4) |
Rural | 236 (2.0) | 96 (2.3) | 30 (2.6) | 57 (6.8) | 22 (0.8) | 22 (0.8) | 11 (0.6) |
Percent of population Hispanic | |||||||
≥50 | 4694 (38.8) | 1196 (28.0) | 296 (25.7) | 206 (24.5) | 1697 (64.8) | 562 (43.8) | 737 (38.1) |
25–49 | 3858 (31.9) | 1429 (33.4) | 402 (34.9) | 274 (32.5) | 640 (24.5) | 382 (29.8) | 731 (37.8) |
<25 | 3554 (29.4) | 1651 (38.6) | 455 (39.5) | 362 (43.0) | 281 (10.7) | 340 (26.5) | 465 (24.1) |
Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|
All Latinos | Total, n | Not retained in care, n (%) | Crude OR for non-retention in care (95% CI) | Adjusted OR for non-retention in care (95% CI) | Adjusted OR for non-retention in care (95% CI) |
Race | |||||
Black | 740 | 251 (33.9) | 1.11 (0.94–1.29) | 1.08 (0.92–1.28) | 1.11 (0.93–1.31) |
White | 11,366 | 3605 (31.7) | Referent | Referent | Referent |
Country of birth | |||||
United States | 4276 | 1399 (32.7) | Referent | Referent | Referent |
Puerto Rico | 1153 | 377 (32.7) | 1.00 (0.87–1.15) | 0.99 (0.85–1.14) | 1.00 (0.86–1.16) |
Mexico | 842 | 415 (49.3) | 2.00 (1.72–2.32) | 1.99 (1.70–2.33) | 2.00 (1.70–2.36) |
Cuba | 2618 | 493 (18.8) | 0.48 (0.43–0.54) | 0.54 (0.48–0.61) | 0.52 (0.45–0.59) |
Central America | 1284 | 497 (38.7) | 1.30 (1.14–1.48) | 1.38 (1.20–1.58) | 1.33 (1.16–1.53) |
South America | 1933 | 675 (34.9) | 1.10 (0.99–1.24) | 1.17 (1.04–1.32) | 1.11 (0.98–1.26) |
Central American and U.S. born | Total, n | Not retained in care, n (%) | Crude OR for non-retention in care (95% CI) | Adjusted OR for non-retention in care (95% CI) | Adjusted OR for non-retention in care (95% CI) |
Country of birth | |||||
United States | 4276 | 1399 (32.7) | Referent | Referent | Referent |
Costa Rica | 56 | 22 (39.3) | 1.33 (0.78–2.28) | 1.37 (0.78–2.40) | 1.36 (0.77–2.24) |
Guatemala | 248 | 132 (53.2) | 2.34 (1.81–3.03) | 2.44 (1.85–3.22) | 2.39 (1.80–3.18) |
Honduras | 496 | 197 (39.7) | 1.36 (1.12–1.64) | 1.44 (1.18–1.76) | 1.39 (1.13–1.72) |
Nicaragua | 299 | 90 (30.1) | 0.89 (0.69–1.14) | 0.99 (0.76–1.29) | 0.94 (0.71–1.23) |
Panama | 77 | 21 (27.3) | 0.77 (0.47–1.28) | 0.89 (0.53–1.51) | 0.90 (0.53–1.52) |
El Salvador | 111 | 38 (34.2) | 1.07 (0.72–1.59) | 1.03 (0.68–1.57) | 1.03 (0.67–1.57) |
Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|
All Latinos | Total, n | Not virally suppressed, n (%) | Crude OR for non-viral suppression (95% CI) | Adjusted OR for non-viral suppression (95% CI) | Adjusted OR for non-viral suppression (95% CI) |
Race | |||||
Black | 740 | 299 (40.4) | 1.23 (1.05–1.43) | 1.19 (1.04–1.37) | 1.16 (0.98–1.36) |
White | 11366 | 4049 (35.6) | Referent | Referent | Referent |
Country of birth | |||||
United States | 4276 | 1595 (37.3) | Referent | Referent | Referent |
Puerto Rico | 1153 | 437 (37.9) | 1.03 (0.90–1.17) | 1.02 (0.89–1.17) | 1.02 (0.89–1.18) |
Mexico | 842 | 444 (52.7) | 1.88 (1.62–2.18) | 1.87 (1.60–2.19) | 1.85 (1.57–2.17) |
Cuba | 2618 | 595 (22.7) | 0.50 (0.44–0.55) | 0.58 (0.52–0.66) | 0.56 (0.50–0.64) |
Central America | 1284 | 556 (43.3) | 1.28 (1.13–1.46) | 1.36 (1.19–1.55) | 1.28 (1.12–1.47) |
South America | 1933 | 721 (37.3) | 1.00 (0.90–1.12) | 1.10 (0.98–1.24) | 1.07 (0.95–1.21) |
Central American and U.S. born | Total, n | Not virally suppressed, n (%) | Crude OR for non-viral suppression (95% CI) | Adjusted OR for non-viral suppression (95% CI) | Adjusted OR for non-viral suppression (95% CI) |
Country of birth | |||||
United States | 4276 | 1595 (37.3) | Referent | Referent | Referent |
Costa Rica | 56 | 23 (41.1) | 1.17 (0.69–2.00) | 1.28 (0.74–2.22) | 1.25 (0.71–2.18) |
Guatemala | 248 | 141 (56.9) | 2.22 (1.71–2.89) | 2.29 (1.74–3.07) | 2.20 (1.66–2.92) |
Honduras | 496 | 227 (45.8) | 1.41 (1.18–1.71) | 1.52 (1.25–1.85) | 1.42 (1.16–1.74) |
Nicaragua | 299 | 103 (34.5) | 0.88 (0.69–1.13) | 1.01 (0.78–1.30) | 0.94 (0.73–1.23) |
Panama | 77 | 22 (28.6) | 0.67 (0.41–1.11) | 0.78 (0.47–1.30) | 0.77 (0.46–1.29) |
El Salvador | 111 | 43 (38.7) | 1.06 (0.72–1.57) | 1.06 (0.71–1.58) | 1.03 (0.68–1.54) |
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Sheehan, D.M.; Mauck, D.E.; Fennie, K.P.; Cyrus, E.A.; Maddox, L.M.; Lieb, S.; Trepka, M.J. Black–White and Country of Birth Disparities in Retention in HIV Care and Viral Suppression among Latinos with HIV in Florida, 2015. Int. J. Environ. Res. Public Health 2017, 14, 120. https://doi.org/10.3390/ijerph14020120
Sheehan DM, Mauck DE, Fennie KP, Cyrus EA, Maddox LM, Lieb S, Trepka MJ. 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; 14(2):120. https://doi.org/10.3390/ijerph14020120
Chicago/Turabian StyleSheehan, Diana M., Daniel E. Mauck, Kristopher P. Fennie, Elena A. Cyrus, Lorene M. Maddox, Spencer Lieb, and Mary Jo Trepka. 2017. "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 14, no. 2: 120. https://doi.org/10.3390/ijerph14020120