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Kerani RP, Lugg A, Berzins B, Gaye O, Lipira LE, Bundy C, Kwakwa H, Holmes KK, Golden MR. Post-migration HIV acquisition among african immigrants in the U.S. J Immigr Minor Health 2022; 24:1459-1468. [PMID: 35415766 PMCID: PMC9554041 DOI: 10.1007/s10903-022-01356-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND African immigrants in the U.S. are more likely to have a late HIV diagnosis than U.S.-born people, potentially leading to onward transmission. We sought to determine the proportion of African-born people living with HIV (APLWH) who (1) had tested HIV negative prior to diagnosis, and (2) likely acquired HIV in the U.S. METHODS We interviewed APLWH from 2014 to 2017 and estimated the proportion with post-migration HIV acquisition based on clinical data, HIV testing history, immigration date, and behavioral data. RESULTS Of 179 participants, 113 (63%) were women. Less than half (44%) reported a negative HIV test prior to diagnosis. Among 142 (79%) participants with sufficient data to evaluate post-migration HIV acquisition, we estimate that 29% acquired HIV post-migration. Most APLWH acquire HIV prior to immigration. DISCUSSION Approximately one-quarter of APLWH acquire HIV post-migration and HIV testing is infrequent, highlighting the need for prevention efforts for African immigrants in the U.S.
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Affiliation(s)
- Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, WA, United States.
- HIV/STD Program, Public Health - Seattle and King County, Seattle, WA, United States.
- Department of Epidemiology, University of Washington, Seattle, WA, United States.
- Center for AIDS and STD, Harborview Medical Center, 325 9th Ave, Box 359932, 98104, Seattle, WA, United States.
| | - Amanda Lugg
- African Services Committee, New York, NY, United States
| | - Baiba Berzins
- Division of Infectious Diseases, Northwestern University, Evanston, IL, United States
| | - Oumar Gaye
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - Lauren E Lipira
- Department of Health Services, University of Washington, Seattle, WA , United States
- Oregon Health Authority and the Regional Research Institute, Portland State University, Portland, OR, United States
| | - Camille Bundy
- Division of Infectious Diseases, Northwestern University, Evanston, IL, United States
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Helena Kwakwa
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - King K Holmes
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Matthew R Golden
- Department of Medicine, University of Washington, Seattle, WA, United States
- HIV/STD Program, Public Health - Seattle and King County, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
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Grieb SM, Flores-Miller A, Sherman SG, Page KR. Sex work within emerging Latino immigrant communities: a typology. CULTURE, HEALTH & SEXUALITY 2022; 24:374-390. [PMID: 33252308 PMCID: PMC9284526 DOI: 10.1080/13691058.2020.1847324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
Little is known about the organisation and types of sex work emerging urban Latino immigrant communities. To develop a typology of the local sex work industry, we conducted 39 in-depth interviews with foreign-born and US-born Latina female sex workers, Latino immigrant clients, and key informants such as bartenders and brothel managers in Baltimore, Maryland, USA. Interview transcripts were coded through an iterative process, and descriptions of sex work were grouped into types. Three types of direct sex work (the street, houses that operate as brothels, and weekend brothels operating out of hotels), three types of indirect sex work (bar workers, opportunistic, and as-needed), and one type that could be either direct or indirect (individual arrangements) were identified. Understanding the local sex industry and its variability has implications for developing and implementing programmes and interventions tailored to the context of sex work type in order to reduce HIV transmission.
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Affiliation(s)
- Suzanne M Grieb
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Susan G Sherman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathleen R Page
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Gant Z, Johnson Lyons S, Jin C, Dailey A, Nwangwu-Ike N, Satcher Johnson A. Geographic Differences in Social Determinants of Health Among US-Born and Non-US-Born Hispanic/Latino Adults With Diagnosed HIV Infection, United States and Puerto Rico, 2017. Public Health Rep 2021; 136:685-698. [PMID: 33563091 DOI: 10.1177/0033354920970539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE HIV disproportionately affects Hispanic/Latino people in the United States, and factors other than individual attributes may be contributing to these differences. We examined differences in the distribution of HIV diagnosis and social determinants of health (SDH) among US-born and non-US-born Hispanic/Latino adults in the United States and Puerto Rico. METHODS We used data reported to the Centers for Disease Control and Prevention's National HIV Surveillance System (NHSS) to determine US census tract-level HIV diagnosis rates and percentages among US-born and non-US-born Hispanic/Latino adults aged ≥18 for 2017. We merged data from the US Census Bureau's American Community Survey with NHSS data to examine regional differences in federal poverty level, education, median household income, employment, and health insurance coverage among 8648 US-born (n = 3328) and non-US-born (n = 5320) Hispanic/Latino adults. RESULTS A comparison of US-born and non-US-born men by region showed similar distributions of HIV diagnoses. The largest percentages occurred in census tracts where ≥19% of residents lived below the federal poverty level, ≥18% did not finish high school, the median household income was <$40 000 per year, ≥6% were unemployed, and ≥16% did not have health insurance. A comparison of US-born and non-US-born women by region showed similar distributions. CONCLUSION The findings of higher numbers of HIV diagnoses among non-US-born Hispanic/Latino adults than among US-born Hispanic/Latino adults, regional similarities in patterns of SDH and HIV percentages and rates, and Hispanic/Latino adults faring poorly in each SDH category are important for understanding SDH barriers that may be affecting Hispanic/Latino adults with HIV in the United States.
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Affiliation(s)
- Zanetta Gant
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shacara Johnson Lyons
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - André Dailey
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ndidi Nwangwu-Ike
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anna Satcher Johnson
- 1242 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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4
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Kamalyan L, Hussain MA, Diaz MM, Umlauf A, Franklin DR, Cherner M, Mindt MR, Fortuny LAI, Grant I, Heaton RK, Marquine MJ. Neurocognitive impairment in Spanish-speaking Latinos living with HIV in the US: Application of the neuropsychological norms for the US-Mexico border region in Spanish (NP-NUMBRS). Clin Neuropsychol 2021; 35:433-452. [PMID: 31847711 PMCID: PMC7453430 DOI: 10.1080/13854046.2019.1701084] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 11/01/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023]
Abstract
Objective Latinos in the US are at increased risk for HIV-associated neurocognitive impairment (NCI). Most studies of US Latinos living with HIV have included primarily English-speakers only. We investigated the rate, pattern, and correlates of HIV-associated NCI in native Spanish-speaking Latinos living in the US near the Mexican border. Methods Participants included 407 native Spanish-speaking Latinos (Age: M = 37.65, SD = 10.0; Education: M = 10.75, SD = 4.1; 53% male): 153 persons living with HIV (PLWH; 56% AIDS) and 254 healthy controls. All participants completed comprehensive neuropsychological assessments in Spanish. Raw neuropsychological test scores from seven domains were converted to demographically-adjusted T-scores using norms developed with healthy controls. Global and domain NCI were defined per established criteria. Among PLWH we applied norms developed for non-Hispanic (NH) Whites and Blacks, and investigated correlates of global NCI, including HIV disease characteristics and psychiatric comorbidities. Results Utilizing population specific norms, rates of global NCI were significantly higher among PLWH (39%) than healthy controls (17%), comparable to previously published rates. In contrast, rates of global NCI in the same group of PLWH were significantly different when NH White norms (63%, p < 0.0001) and NH Black norms were used (18%, p < 0.0001). Among PLWH without a history of lifetime substance use disorder, more years of antiretroviral exposure were significantly associated with decreased rates of global NCI. Conclusions Present findings lend support to the validity of newly developed norms for native Spanish-speakers living near the US-Mexico border, and underscore the importance of utilizing appropriate norms to accurately identify HIV-associated NCI.
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Affiliation(s)
- Lily Kamalyan
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
| | - Mariam A. Hussain
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
| | - Monica M. Diaz
- Department of Neurosciences, University of California, San Diego
| | - Anya Umlauf
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Donald R. Franklin
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Mariana Cherner
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Monica Rivera Mindt
- Department of Psychology & Latin American Latino Studies Institute, Fordham University and Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Igor Grant
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - Robert K. Heaton
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
| | - María J. Marquine
- Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego
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Kerani RP, Satcher Johnson A, Buskin SE, Rao D, Golden MR, Hu X, Hall HI. The Epidemiology of HIV Among People Born Outside the United States, 2010-2017. Public Health Rep 2020; 135:611-620. [PMID: 32805191 DOI: 10.1177/0033354920942623] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Although some studies have reported a higher incidence of HIV infection among non-US-born people than among US-born people, national data on this topic are scarce. We compared the epidemiology of HIV infection between US-born and non-US-born residents of the United States and examined the characteristics of non-US-born people with diagnosed HIV infection by region of birth (ROB). METHODS We used a cross-sectional study design to produce national, population-based data describing HIV infection among US-born and non-US-born people. We analyzed National HIV Surveillance System data for people with HIV infection diagnosed during 2010-2017 and reported to the Centers for Disease Control and Prevention (CDC). We compared data on demographic characteristics, transmission risk category, and stage 3 infection (AIDS) classification within 3 months of HIV diagnosis, by nativity and ROB. RESULTS During 2010-2017, 328 317 children and adult US residents were diagnosed with HIV infection and were reported to CDC: 214 973 (65.5%) were US-born, 50 301 (15.3%) were non-US-born, and 63 043 (19.2%) were missing data on country of birth. After adjusting for missing country of birth, 266 147 (81.1%) people were US-born and 62 170 (18.9%) were non-US-born. This group accounted for 15 928 of 65 645 (24.2%) HIV diagnoses among girls and women and 46 242 of 262 672 (17.6%) HIV diagnoses among boys and men. A larger percentage of non-US-born people than US-born people had stage 3 infection (AIDS) at HIV diagnosis (31.2% vs 23.9%). Among non-US-born people with HIV diagnoses, 19 876 (39.5%) resided in the South. CONCLUSIONS Characterizing non-US-born people with HIV infection is essential for developing effective HIV interventions, particularly in areas with large immigrant populations.
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Affiliation(s)
- Roxanne P Kerani
- 7284 Division of Allergy and Infectious Disease, Department of Medicine, University of Washington, Seattle, WA, USA.,7285 HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA.,7284 Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Anna Satcher Johnson
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan E Buskin
- 7285 HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA.,7284 Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Deepa Rao
- 7284 Department of Global Health, University of Washington, Seattle, WA, USA
| | - Matthew R Golden
- 7284 Division of Allergy and Infectious Disease, Department of Medicine, University of Washington, Seattle, WA, USA.,7285 HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA.,7284 Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Xiaohong Hu
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H Irene Hall
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Benbow ND, Aaby DA, Rosenberg ES, Brown CH. County-level factors affecting Latino HIV disparities in the United States. PLoS One 2020; 15:e0237269. [PMID: 32785252 PMCID: PMC7423131 DOI: 10.1371/journal.pone.0237269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/22/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To determine which county-level social, economic, demographic, epidemiologic and access to care factors are associated with Latino/non-Latino White disparities in prevalence of diagnosed HIV infection. METHODS AND FINDINGS We used 2016 county-level prevalence rates of diagnosed HIV infection rates for Latinos and non-Latino Whites obtained from the National HIV Surveillance System and factors obtained from multiple publicly available datasets. We used mixed effects Poisson modeling of observed HIV prevalence at the county-level to identify county-level factors that explained homogeneous effects across race/ethnicity and differential effects for Latinos and NL-Whites. Overall, the median Latinos disparity in HIV prevalence is 2.4; 94% of the counties have higher rates for Latinos than non-Latinos, and one-quarter of the counties' disparities exceeded 10. Of the 41 county-level factors examined, 24 showed significant effect modification when examined individually. In multi-variable modeling, 11 county-level factors were found that significantly affected disparities. Factors that increased disparity with higher, compared to lower values included proportion of HIV diagnoses due to injection drug use, percent Latino living in poverty, percent not English proficient, and percent Puerto Rican. Latino disparities increased with decreasing percent severe housing, drug overdose mortality rate, percent rural, female prevalence rate, social association rate, percent change in Latino population, and Latino to NL-White proportion of the population. These factors while significant had minimal effects on diminishing disparity, but did substantially reduce the variance in disparity rates. CONCLUSIONS Large differences in HIV prevalence rates persist across almost all counties even after controlling for county-level factors. Counties that are more rural, have fewer Latinos, or have lower NL-White prevalence rates tend to have higher disparities. There is also higher disparity when community risk is low.
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Affiliation(s)
- Nanette D. Benbow
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
| | - David A. Aaby
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Eli S. Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, New York, United States of America
| | - C. Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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Valverde E, DiNenno E, Oraka E, Bautista G, Chavez P. HIV Testing Among Foreign-Born Men and Women in the United States: Results from a Nationally Representative Cross-Sectional Survey. J Immigr Minor Health 2019; 20:1118-1127. [PMID: 28916888 DOI: 10.1007/s10903-017-0655-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
HIV disproportionately affects the foreign-born population in the United States. This analysis describes the prevalence of ever-testing for HIV among foreign-born individuals residing in the United States. Data from a national health survey of the civilian, non-institutionalized population was used to describe prevalence of ever-testing for HIV among foreign-born individuals by birth place. Multivariate logistic-regression procedures were used to determine factors associated with ever-testing for HIV among foreign-born men and women. The prevalence of ever-testing for HIV among foreign-born individuals varied by region of birth ranging from 31 to 67%. Factors related to ever-testing for HIV varied by gender. Efforts need to continue in order to improve HIV testing rates among Asian foreign-born individuals, lower educated foreign-born and foreign-born gay/bisexual men. Health care providers can play an important role by counseling new arrivals regarding the importance of testing for HIV and practicing HIV risk reduction activities.
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Affiliation(s)
- Eduardo Valverde
- Division of Global HIV & TB, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mail Stop E-04, Atlanta, GA, 30329, USA.
| | - Elizabeth DiNenno
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emeka Oraka
- ICF International, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gregory Bautista
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pollyanna Chavez
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Levison JH, Levinson JK, Alegría M. A Critical Review and Commentary on the Challenges in Engaging HIV-Infected Latinos in the Continuum of HIV Care. AIDS Behav 2018; 22:2500-2512. [PMID: 29948334 DOI: 10.1007/s10461-018-2187-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Antiretroviral therapy for treatment of HIV infection has become increasingly effective. Persistent poor HIV outcomes in racial and ethnic minority populations in the US call for a closer examination into why Latinos are at significant risk for acquiring and dying from HIV. To improve clinical outcomes and achieve an AIDS-free generation, HIV research must address disparities in HIV outcomes in Latinos, the largest ethnic/racial minority population in the US. Immigrant status as well as cultural factors influence HIV care utilization and are essential to highlight for effective intervention development in Latinos. A better understanding of these individual and contextual factors is critical to developing tailored approaches to engaging Latinos in HIV care. Based on a comprehensive literature review, we offer a framework for understanding what is needed from clinical practice and research to improve engagement in HIV care for US-based Latinos. These findings may have implications for other minority populations.
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Kerani R, Bennett AB, Golden M, Castillo J, Buskin SE. Foreign-Born Individuals with HIV in King County, WA: A Glimpse of the Future of HIV? AIDS Behav 2018; 22:2181-2188. [PMID: 28965262 DOI: 10.1007/s10461-017-1914-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To better understand country of birth-related shifts in the demography of people newly diagnosed with HIV infection, we compared demographic and clinical characteristics of foreign-born and U.S.-born residents of King County, WA diagnosed with HIV from 2006 to 2015. The proportion of cases that were foreign-born increased from 23 to 34% during this time. Most foreign-born cases were born in Africa (34%), Latin America (32%), Asia (22%), or Europe (7%). Latin Americans and Asians were similar to U.S.-born individuals by HIV risk factor and gender, while Africans were more likely to be female and less often men who have sex with men. In 2015, approximately 15% of cases presumptively newly diagnosed in King County were foreign-born individuals who self-reported a pre-immigration HIV diagnosis. Increases in foreign-born individuals previously diagnosed out of country may lead to inaccuracy in the count of new diagnoses, including an over-estimate of community-acquired HIV in King County.
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Affiliation(s)
- Roxanne Kerani
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, USA.
- Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA.
- Center for AIDS and STD, Harborview Medical Center, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA.
| | - Amy B Bennett
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, USA
| | - Matt Golden
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, USA
- Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA
| | - Jocelyn Castillo
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, USA
| | - Susan E Buskin
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, USA
- Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA
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10
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Friedman EE, Dean HD, Duffus WA. Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Rep 2018; 133:392-412. [PMID: 29874147 DOI: 10.1177/0033354918774788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Social determinants of health (SDHs) are the complex, structural, and societal factors that are responsible for most health inequities. Since 2003, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) has researched how SDHs place communities at risk for communicable diseases and poor adolescent health. We described the frequency and types of SDHs discussed in articles authored by NCHHSTP. METHODS We used the MEDLINE/PubMed search engine to systematically review the frequency and type of SDHs that appeared in peer-reviewed publications available in PubMed from January 1, 2009, through December 31, 2014, with a NCHHSTP affiliation. We chose search terms to identify articles with a focus on the following SDH categories: income and employment, housing and homelessness, education and schooling, stigma or discrimination, social or community context, health and health care, and neighborhood or built environment. We classified articles based on the depth of topic coverage as "substantial" (ie, one of ≤3 foci of the article) or "minimal" (ie, one of ≥4 foci of the article). RESULTS Of 862 articles authored by NCHHSTP, 366 (42%) addressed the SDH factors of interest. Some articles addressed >1 SDH factor (366 articles appeared 568 times across the 7 categories examined), and we examined them for each category that they addressed. Most articles that addressed SDHs (449/568 articles; 79%) had a minimal SDH focus. SDH categories that were most represented in the literature were health and health care (190/568 articles; 33%) and education and schooling (118/568 articles; 21%). CONCLUSIONS This assessment serves as a baseline measurement of inclusion of SDH topics from NCHHSTP authors in the literature and creates a methodology that can be used in future assessments of this topic.
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Affiliation(s)
- Eleanor E Friedman
- 1 Association of Schools and Programs of Public Health/CDC Public Health Fellowship Program, Atlanta, GA, USA.,2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.,3 Chicago Center for HIV Elimination and University of Chicago Department of Medicine, Chicago, IL, USA
| | - Hazel D Dean
- 4 Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wayne A Duffus
- 2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Sheehan DM, Trepka MJ, Fennie KP, Prado G, Madhivanan P, Dillon FR, Maddox LM. Individual and Neighborhood Determinants of Late HIV Diagnosis Among Latinos, Florida, 2007-2011. J Immigr Minor Health 2018; 19:825-834. [PMID: 27119364 DOI: 10.1007/s10903-016-0422-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
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 foreign-born, residing in areas in the 2nd and 3rd quartiles of unemployment, in rural areas, and areas with <25 % Hispanic/Latino population were associated with late diagnosis. Population-based HIV testing campaigns may require tailoring to ensure that they effectively reach male Latinos in areas with high unemployment and foreign-born Latinos in rural and predominantly non-Latino areas.
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Affiliation(s)
- Diana M Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. .,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA.
| | - Kristopher P Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136, USA
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA
| | - Frank R Dillon
- Department of Educational and Counseling Psychology, School of Education, University at Albany - State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA
| | - Lorene M Maddox
- HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL, 32399, USA
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Sheehan DM, Cosner C, Fennie KP, Gebrezgi MT, Cyrus E, Maddox LM, Levison JH, Spencer EC, Niyonsenga T, Trepka MJ. Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos. AIDS Patient Care STDS 2018; 32:165-173. [PMID: 29630853 DOI: 10.1089/apc.2018.0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The objective of this study was to estimate disparities in linkage to human immunodeficiency virus (HIV) care among Latinos by country/region of birth, HIV testing site, and neighborhood characteristics. A retrospective study was conducted using Florida HIV surveillance records of Latinos/Hispanics aged ≥13 diagnosed during 2014-2015. Linkage to HIV care was defined as a laboratory test (HIV viral load or CD4) within 3 months of HIV diagnosis. Multi-level Poisson regression models were used to estimate adjusted prevalence ratios (aPR) for nonlinkage to care. Of 2659 Latinos, 18.8% were not linked to care within 3 months. Compared with Latinos born in mainland United States, those born in Cuba [aPR 0.60, 95% confidence interval (CI) 0.47-0.76] and Puerto Rico (aPR 0.61, 95% CI 0.41-0.90) had a decreased prevalence of nonlinkage. Latinos diagnosed at blood banks (aPR 2.34, 95% CI 1.75-3.12), HIV case management and screening facilities (aPR 1.76, 95% CI 1.46-2.14), and hospitals (aPR 1.42, 95% CI 1.03-1.96) had an increased prevalence of nonlinkage compared with outpatient general, infectious disease, and tuberculosis/sexually transmitted diseases/family planning clinics. Latinos who resided in the lowest (aPR 1.57, 95% CI 1.19-2.07) and third lowest (aPR 1.33, 95% CI 1.01-1.76) quartiles of neighborhood socioeconomic status compared with the highest quartile were at increased prevalence. Latinos who resided in neighborhoods with <25% Latinos also had increased prevalence of nonlinkage (aPR 1.23, 95% CI 1.01-1.51). Testing site at diagnosis may be an important determinant of HIV care linkage among Latinos due to neighborhood or individual-level resources that determine location of HIV testing.
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Affiliation(s)
- Diana M. Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, Florida
| | - Chelsea Cosner
- Herbert Wertheim College of Medicine, Florida International University, Miami Florida
| | - Kristopher P. Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Merhawi T. Gebrezgi
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Elena Cyrus
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, Florida
| | - Lorene M. Maddox
- HIV/AIDS Section, Florida Department of Health, Tallahassee, Florida
| | - Julie H. Levison
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emma C. Spencer
- HIV/AIDS Section, Florida Department of Health, Tallahassee, Florida
| | | | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
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Valverde EE, Painter T, Heffelfinger JD, Schulden JD, Chavez P, DiNenno EA. Migration Patterns and Characteristics of Sexual Partners Associated with Unprotected Sexual Intercourse Among Hispanic Immigrant and Migrant Women in the United States. J Immigr Minor Health 2017; 17:1826-33. [PMID: 25403987 DOI: 10.1007/s10903-014-0132-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 2011, Hispanic immigrant women comprised 44% of HIV diagnoses among Hispanic women in the United States but little is known about factors that may place these women at risk for infection with HIV or sexually transmitted diseases. From March 2005 to February 2007, women were recruited at community-based organizations offering services to immigrant and migrant communities in five U.S. states. We report factors independently associated with unprotected anal and vaginal sex in the past 12 months among Hispanic immigrant and migrant women. Greater work-related mobility was associated with unprotected anal sex, while recency of immigration and prior refusal of HIV testing were associated with women's reports of unprotected vaginal sex. Prior sex with an injection drug user was associated with reports of both unprotected anal and vaginal sex. Findings highlight the need for HIV/STD risk reduction interventions designed specifically for Hispanic immigrant and migrant women.
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Affiliation(s)
- Eduardo E Valverde
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Thomas Painter
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - James D Heffelfinger
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jeffrey D Schulden
- National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH) Neuroscience Center, Bethesda, MD, USA.
| | - Pollyanna Chavez
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Elizabeth A DiNenno
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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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:ijerph14020120. [PMID: 28134795 PMCID: PMC5334674 DOI: 10.3390/ijerph14020120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 11/16/2022]
Abstract
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% CI 1.66-2.92) and Honduras (retention aOR 1.39, 95% CI 1.13-1.72; VL 1.42, 95% CI 1.16-1.74) experienced the largest disparities, when compared to U.S.-born Latinos. Disparities in care and treatment exist within the Latino population. Cultural and other factors, unique to Latino Black-White racial and birth country subgroups, should be further studied and considered for intervention.
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Gray KM, Valverde EE, Tang T, Siddiqi AEA, Hall HI. Diagnoses and Prevalence of HIV Infection Among Hispanics or Latinos - United States, 2008-2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2015; 64:1097-103. [PMID: 26448539 DOI: 10.15585/mmwr.mm6439a2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Hispanics or Latinos represent about 17% of the total U.S. population and are disproportionately affected by human immunodeficiency virus (HIV) infection in the United States. In 2013, the rate of HIV diagnosis among Hispanics or Latinos (18.7) was nearly three times that of non-Hispanic whites (6.6). To better characterize HIV infection among Hispanics or Latinos aged ≥13 years in the United States, CDC analyzed data from the National HIV Surveillance System (NHSS). During 2008-2013, the rate of diagnoses of HIV infection among adult and adolescent Hispanics or Latinos decreased from 28.3 per 100,000 population in 2008 to 24.3 in 2013 (estimated annual percentage change [EAPC] = -3.6); however, the number of diagnoses among males with infection attributed to male-to-male sexual contact increased 16%, from 6,141 in 2008 to 7,098 in 2013 (EAPC = 3.0). In 2013, the rate of diagnosis of HIV infection among males (41.3) was six times the rate among females (6.8). During 2008-2013, behavioral risk factors for HIV infection among Hispanics or Latino differed among males and females and by place of birth. Among Hispanic or Latino males born in Puerto Rico, the proportion of HIV infections attributed to injection drug use (24.9%) was greater than among those born elsewhere. Among HIV-infected Hispanic or Latino females, those born in the United States (21.2%) and Puerto Rico (20.5%) had a greater proportion of HIV infections attributed to injection drug use than those born elsewhere. Additional interventions and public health strategies to further decrease the rates of HIV among the Hispanic or Latino population are needed.
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Sheehan DM, Trepka MJ, Fennie KP, Prado G, Madhivanan P, Dillon FR, Maddox L. Individual and neighborhood predictors of mortality among HIV-positive Latinos with history of injection drug use, Florida, 2000-2011. Drug Alcohol Depend 2015. [PMID: 26208792 PMCID: PMC4536123 DOI: 10.1016/j.drugalcdep.2015.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The objectives are to examine disparities in all-cause mortality risk among HIV-positive Latinos with injection drug use (IDU) history, and to identify individual- and neighborhood-level predictors. METHODS Florida surveillance data for persons diagnosed with HIV 2000-2008 were merged with 2007-2011 administrative data from the American Community Survey. Hazard ratios (HR) were calculated using multi-level weighted Cox regression adjusting for individual and neighborhood (ZCTA-level) factors. RESULTS Of 10,989 HIV-positive Latinos, 10.3% had IDU history. Latinos with IDU history were at increased mortality risk compared with Latinos without IDU history after controlling for individual and neighborhood factors (adjusted HR [aHR] 1.61, 95% confidence interval [CI] 1.43-1.80). Factors associated with mortality for those with IDU history included: being 40-59 (aHR 6.48, 95% CI 1.41-121.05) and ≥60 years (aHR 18.75, 95% CI 3.83-356.45) compared with 13-19 years of age; being diagnosed with AIDS within 3 months of HIV (aHR 2.31, 95% CI 1.87-2.86); residing in an area with ≥50% Latinos compared with <25% Latinos (aHR 1.56, 95% CI 1.19-2.04); and residing in a rural compared with an urban area at the time of diagnosis (aHR 1.73, 95% CI 1.06-2.70). Race and neighborhood poverty were not predictors among those with IDU, but were among those without. CONCLUSION HIV-positive Latinos with IDU history are at increased mortality risk and have unique contributing factors. Tertiary prevention strategies should target those who are older, diagnosed at later stages, and those who live in predominantly Latino and rural areas.
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Affiliation(s)
- Diana M. Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (CSALUD), Florida International University, 11200 SW 8th St, Miami, FL, 33199,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, 11200 SW 8th St, Miami, FL 33199, United States; Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL 33199, United States.
| | - Kristopher P. Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Frank R. Dillon
- Department of Educational and Counseling Psychology, School of Education, University at Albany – State University of New York, 1400 Washington Ave, Albany, NY, 12222
| | - Lorene Maddox
- HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, Florida 32399
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Sheehan DM, Trepka MJ, Fennie KP, Dillon FR, Madhivanan P, Maddox LM. Neighborhood Latino ethnic density and mortality among HIV-positive Latinos by birth country/region, Florida, 2005-2008. ETHNICITY & HEALTH 2015; 21:268-283. [PMID: 26159480 PMCID: PMC4707125 DOI: 10.1080/13557858.2015.1061104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Lower mortality for Latinos has been reported in high Latino density areas. The objective was to examine the contribution of neighborhood Latino density to mortality among HIV-positive Latinos. METHODS Florida HIV surveillance data for 2005-2008 were merged with the 2007-2011 American Community Survey data using zip code tabulation areas. Hazard ratios (HR) were calculated using multi-level weighted Cox regression and adjusted for individual-level factors and neighborhood poverty. RESULTS Of 4649 HIV-positive Latinos, 11.8% died. There was no difference in mortality risk across categories of Latino ethnic density for Latinos as a whole. There were subgroup effects wherein mortality risk differed by ethnic density category for Latinos born in some countries/regions. Residing in an area with ≥50% Latinos compared with <25% was associated with increased mortality risk for Latinos born in Puerto Rico (HR 1.67; 95% confidence interval [CI] [1.01-2.70]). Residing in an area where Mexicans were the majority Latino group was associated with increased mortality risk for Latinos born in Mexico (HR 3.57; 95% CI [1.43-10.00]). CONCLUSIONS The survival advantage seen among the Latino population in high Latino density areas was not seen among HIV-positive Latinos. Research is needed to determine if this may be related to stigma or another mechanism.
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Affiliation(s)
- Diana M. Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Kristopher P. Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Frank R. Dillon
- Department of Educational and Counseling Psychology, School of Education, University at Albany – State University of New York, 1400 Washington Ave, Albany, NY, 12222
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199
| | - Lorene M. Maddox
- HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, Florida 32399
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Martínez-Donate AP, Rangel MG, Rhoads N, Zhang X, Hovell M, Magis-Rodriguez C, González-Fagoaga E. Identifying opportunities to increase HIV testing among mexican migrants: a call to step up efforts in health care and detention settings. PLoS One 2015; 10:e0123631. [PMID: 25860261 PMCID: PMC4393219 DOI: 10.1371/journal.pone.0123631] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/02/2015] [Indexed: 11/18/2022] Open
Abstract
HIV testing and counseling is a critical component of HIV prevention efforts and core element of current “treatment as prevention” strategies. Mobility, low education and income, and limited access to health care put Latino migrants at higher risk for HIV and represent barriers for adequate levels of HIV testing in this population. We examined correlates of, and missed opportunities to increase, HIV testing for circular Mexican migrants in the U.S. We used data from a probability-based survey of returning Mexican migrants (N=1161) conducted in the border city of Tijuana, Mexico. We estimated last 12-months rates of HIV testing and the percentage of migrants who received other health care services or were detained in an immigration center, jail, or prison for 30 or more days in the U.S., but were not tested for HIV. Twenty-two percent of migrants received HIV testing in the last 12 months. In general, utilization of other health care services or detention for 30 or more days in the U.S. was a significant predictor of last 12-months HIV testing. Despite this association, we found evidence of missed opportunities to promote testing in healthcare and/or correctional or immigration detention centers. About 27.6% of migrants received other health care and/or were detained at least 30 days but not tested for HIV. Health care systems, jails and detention centers play an important role in increasing access to HIV testing among circular migrants, but there is room for improvement. Policies to offer opt-out, confidential HIV testing and counseling to Mexican migrants in these settings on a routine and ethical manner need to be designed and pilot tested. These policies could increase knowledge of HIV status, facilitate engagement in HIV treatment among a highly mobile population, and contribute to decrease incidence of HIV in the host and receiving communities.
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Affiliation(s)
- Ana P. Martínez-Donate
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
- * E-mail:
| | | | - Natalie Rhoads
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Xiao Zhang
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Melbourne Hovell
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Carlos Magis-Rodriguez
- Centro de Investigaciones en Infecciones de Transmision Sexual, Programa de VIH y SIDA de la Ciudad de Mexico, la Ciudad de Mexico, Mexico
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Clark H, Surendera Babu A, Harris S, Hardnett F. HIV-Related Mortality Among Adults (≥ 18 years) of Various Hispanic or Latino Subgroups--United States, 2006-2010. J Racial Ethn Health Disparities 2015; 2:53-61. [PMID: 26863241 PMCID: PMC5381268 DOI: 10.1007/s40615-014-0047-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/29/2014] [Accepted: 08/22/2014] [Indexed: 10/24/2022]
Abstract
Hispanics or Latinos residing in the USA are disproportionately affected by HIV when compared to whites. Health outcomes for Hispanics or Latinos diagnosed with HIV infection may vary by Hispanic or Latino subgroup. We analyzed national mortality data from the National Center for Health Statistics for the years 2006 to 2010 to examine differences in HIV-related mortality among Hispanics or Latinos by sociodemographic factors and by Hispanic or Latino subgroup. After adjusting for age, HIV-related death rates per 100,000 population were highest among Hispanics or Latinos who were male (45.6, 95 % confidence interval [CI], 44.4 to 46.9) compared to female (12.0, 95 % CI 11.4 to 12.6), or resided in the Northeast (75.1, 95 % CI 72.2 to 77.9) compared to other US regions at the time of death. The age-adjusted HIV-related death rate was highest among Puerto Ricans (100.9, 95 % CI 97.0 to 104.8) and lowest among Mexicans (16.9, 95 % CI 16.2 to 17.6). Among all deaths, the proportion of HIV-related deaths was more than four times as high among Puerto Ricans (adjusted prevalence ratio = 4.3, 95 % CI 4.1 to 4.5) compared to Mexicans. To ensure better health outcomes for Hispanics or Latinos living with HIV in the USA, medical care and treatment programs should be adapted to address the needs of various Hispanic or Latino subgroups.
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Affiliation(s)
- Hollie Clark
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E47, Atlanta, GA, 30329, USA.
| | | | | | - Felicia Hardnett
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, MS E48, Atlanta, GA, 30329, USA
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Sheehan DM, Trepka MJ, Fennie K, Maddox L. Rate of new HIV diagnoses among Latinos living in Florida: disparities by country/region of birth. AIDS Care 2014; 27:507-11. [PMID: 25397859 PMCID: PMC4312518 DOI: 10.1080/09540121.2014.978731] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
HIV incidence in the USA is three times higher for Latinos than for non-Latino whites. Latinos differ in educational attainment, poverty, insurance coverage, and health-care access, factors that affect HIV knowledge, risk behaviors, and testing. The purpose of this study was to identify differences in demographics, risk factors, and rate of new HIV diagnoses by birth country/region among Latinos in Florida to guide the targeting of primary and secondary prevention programs. Using Florida HIV/AIDS surveillance data from 2007 to 2011 and the American Community Survey, we compared demographic and risk factors, and calculated annual and five-year age-adjusted rates of new HIV diagnoses for 5801 Latinos by birth country/region. Compared to US-born Latinos, those born in Cuba and South America were significantly more likely to report the HIV transmission mode of MSM; those born in the Dominican Republic (DR) heterosexual transmission; and those born in Puerto Rico injection drug use. Mexican- and Central American-born Latinos were more likely to be diagnosed with AIDS within a month of HIV diagnosis. The rate of new HIV diagnoses among Latinos declined 33% from 2007 to 2011. HIV diagnoses over time decreased significantly for Latinos born in Mexico and increased nonsignificantly for those born in the DR. Although this study was limited to Latinos living in Florida, results suggest that tailoring HIV primary prevention and testing initiatives to specific Latino groups may be warranted.
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Affiliation(s)
- Diana M. Sheehan
- Department of Epidemiology and C-SALUD Center for Substance Use and AIDS Research on Latinos in the United States, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, PCA 362C, Miami, Florida 33199. ; P: (305) 348-5002
| | - Mary Jo Trepka
- Department of Epidemiology and C-SALUD Center for Substance Use and AIDS Research on Latinos in the United States, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC2 595, Miami, Florida 33199. ; P: (305) 348-7186
| | - Kristopher Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC2 587, Miami, Florida 33199. . P: (305) 348-4545
| | - Lorene Maddox
- HIV/AIDS and Hepatitis Section, Florida Department of Health, 4052 Bald Cypress Way, BIN A09, Tallahassee, Florida 32399. ; P: (850) 245-4444 Ext. 2613
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Deren S, Gelpí-Acosta C, Albizu-García CE, González Á, Des Jarlais DC, Santiago-Negrón S. Addressing the HIV/AIDS epidemic among Puerto Rican people who inject drugs: the need for a multiregion approach. Am J Public Health 2014; 104:2030-6. [PMID: 25211722 DOI: 10.2105/ajph.2014.302114] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
High levels of HIV risk behaviors and prevalence have been reported among Puerto Rican people who inject drugs (PRPWID) since early in the HIV epidemic. Advances in HIV prevention and treatment have reduced HIV among people who inject drugs (PWID) in the United States. We examined HIV-related data for PRPWID in Puerto Rico and the US Northeast to assess whether disparities continue. Injection drug use as a risk for HIV is still overrepresented among Puerto Ricans. Lower availability of syringe exchanges, drug abuse treatment, and antiretroviral treatment for PWID in Puerto Rico contribute to higher HIV risk and incidence. These disparities should be addressed by the development of a federally supported Northeast-Puerto Rico collaboration to facilitate and coordinate efforts throughout both regions.
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Affiliation(s)
- Sherry Deren
- Sherry Deren is with the Center for Drug Use and HIV Research, College of Nursing, New York University, New York, NY. Camila Gelpí-Acosta is a postdoctoral fellow at National Development and Research Institutes (NDRI), New York, NY. Carmen E. Albizu-García is with the Graduate School of Public Health, University of Puerto Rico, San Juan. At the time of writing, Ángel González and Salvador Santiago-Negrón were with the Administración de Servicios de Salud Mental y Contra la Adicción (ASSMCA; Mental Health and Anti-addiction Services Administration), San Juan. Don C. Des Jarlais is with Mount Sinai Beth Israel, New York, NY
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Sheehan DM, Trepka MJ, Dillon FR. Latinos in the United States on the HIV/AIDS care continuum by birth country/region: a systematic review of the literature. Int J STD AIDS 2014; 26:1-12. [PMID: 24810215 DOI: 10.1177/0956462414532242] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Twenty percent of Latinos with HIV in the US are unaware of their HIV status, 33% are linked to care late, and 74% do not reach viral suppression. Disparities along this HIV/AIDS care continuum may be present between various ethnic groups historically categorised as Latino. To identify differences along the HIV/AIDS care continuum between US Latinos of varying birth countries/regions a systematic review of articles published in English between 2002 and 2013 was conducted using MEDLINE, PsycINFO, and Web of Science. Studies that reported on one or more steps of the HIV/AIDS care continuum and reported results by birth country/region for Latinos were included. Latinos born in Mexico and Central America were found to be at increased risk of late diagnosis compared with US-born Latinos. No studies were found that reported on linkage to HIV care or viral load suppression by country/region of birth. Lower survival was found among Latinos born in Puerto Rico compared with Latinos born in mainland US. Inconsistent differences in survival were found among Latinos born in Mexico, Cuba, and Central America. Socio/cultural context, immigration factors, and documentation status are discussed as partial explanations for disparities along the HIV/AIDS care continuum.
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Affiliation(s)
- Diana M Sheehan
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Frank R Dillon
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA School of Social Welfare, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Poon KK, Dang BN, Davila JA, Hartman C, Giordano TP. Treatment outcomes in undocumented Hispanic immigrants with HIV infection. PLoS One 2013; 8:e60022. [PMID: 23555868 PMCID: PMC3608625 DOI: 10.1371/journal.pone.0060022] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 02/21/2013] [Indexed: 11/24/2022] Open
Abstract
Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. We sought to compare the treatment outcomes of undocumented and documented patients 12-months after entering HIV care. Methods We conducted a retrospective cohort study of antiretroviral-naive patients 18 years and older attending their first visit at Thomas Street Health Center in Houston, Texas, between 1/1/2003 and 6/30/2008. The study population of 1,620 HIV-infected adults included 186 undocumented Hispanic, 278 documented Hispanic, 986 Black, and 170 White patients. The main outcome measures were retention in care (quarter years with at least one completed HIV primary care provider visit) and HIV suppression (HIV RNA <400 copies/mL), both measured 12-months after entering HIV care. Results Undocumented Hispanic patients had lower median initial CD4 cell count (132 cells/mm3) than documented Hispanic patients (166 cells/mm3; P = 0.186), Black patients (226 cells/mm3; P<0.001), and White patients (264 cells/mm3; P = 0.001). However, once in care, undocumented Hispanic patients did as well or better than their documented counterparts. One year after entering HIV care, undocumented Hispanics achieved similar rates of retention in care and HIV suppression as documented Hispanic and White patients. Of note, black patients were significantly less likely to have optimal retention in care (adjusted odds ratio [aOR] 0.65, CI = 0.45–0.94) or achieve HIV suppression (aOR 0.32, CI = 0.17–0.61) than undocumented Hispanics. Conclusions Undocumented Hispanic persons with HIV infection enter care with more advanced disease than documented persons, suggesting testing and/or linkage to care efforts for this difficult-to-reach population need intensification. Once diagnosed, however, undocumented Hispanics have outcomes as good as or better than other racial/ethnic groups. Safety net providers for undocumented immigrants are vital for maintaining individual and public health.
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Affiliation(s)
- Kenneth K. Poon
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Bich N. Dang
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas, United States of America
| | - Jessica A. Davila
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas, United States of America
| | - Christine Hartman
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas, United States of America
| | - Thomas P. Giordano
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas, United States of America
- * E-mail:
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Demberg T, Robert-Guroff M. Controlling the HIV/AIDS epidemic: current status and global challenges. Front Immunol 2012; 3:250. [PMID: 22912636 PMCID: PMC3418522 DOI: 10.3389/fimmu.2012.00250] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 07/27/2012] [Indexed: 12/21/2022] Open
Abstract
This review provides an overview of the current status of the global HIV pandemic and strategies to bring it under control. It updates numerous preventive approaches including behavioral interventions, male circumcision (MC), pre- and post-exposure prophylaxis (PREP and PEP), vaccines, and microbicides. The manuscript summarizes current anti-retroviral treatment options, their impact in the western world, and difficulties faced by emerging and resource-limited nations in providing and maintaining appropriate treatment regimens. Current clinical and pre-clinical approaches toward a cure for HIV are described, including new drug compounds that target viral reservoirs and gene therapy approaches aimed at altering susceptibility to HIV infection. Recent progress in vaccine development is summarized, including novel approaches and new discoveries.
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Affiliation(s)
- Thorsten Demberg
- Vaccine Branch, Section on Immune Biology of Retroviral Infection, National Cancer Institute, National Institutes of Health Bethesda, MD, USA
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