Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos

Diana M Sheehan, Chelsea Cosner, Kristopher P Fennie, Merhawi T Gebrezgi, Elena Cyrus, Lorene M Maddox, Julie H Levison, Emma C Spencer, Theophile Niyonsenga, Mary Jo Trepka

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)165-173
Number of pages9
JournalAIDS Patient Care and Stds
Volume32
Issue number4
DOIs
Publication statusPublished - Apr 2018
Externally publishedYes

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Hispanic Americans
HIV
Parturition
Confidence Intervals
Puerto Rico
Blood Banks
Cuba
Family Planning Services
Case Management
Sexually Transmitted Diseases
Viral Load
Social Class
Communicable Diseases
Tuberculosis
Outpatients
Retrospective Studies

Cite this

Sheehan, D. M., Cosner, C., Fennie, K. P., Gebrezgi, M. T., Cyrus, E., Maddox, L. M., ... Trepka, M. J. (2018). Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos. AIDS Patient Care and Stds, 32(4), 165-173. https://doi.org/10.1089/apc.2018.0021
Sheehan, Diana M ; Cosner, Chelsea ; Fennie, Kristopher P ; Gebrezgi, Merhawi T ; Cyrus, Elena ; Maddox, Lorene M ; Levison, Julie H ; Spencer, Emma C ; Niyonsenga, Theophile ; Trepka, Mary Jo. / Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos. In: AIDS Patient Care and Stds. 2018 ; Vol. 32, No. 4. pp. 165-173.
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Sheehan, DM, Cosner, C, Fennie, KP, Gebrezgi, MT, Cyrus, E, Maddox, LM, Levison, JH, Spencer, EC, Niyonsenga, T & Trepka, MJ 2018, 'Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos', AIDS Patient Care and Stds, vol. 32, no. 4, pp. 165-173. https://doi.org/10.1089/apc.2018.0021

Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos. / Sheehan, Diana M; Cosner, Chelsea; Fennie, Kristopher P; Gebrezgi, Merhawi T; Cyrus, Elena; Maddox, Lorene M; Levison, Julie H; Spencer, Emma C; Niyonsenga, Theophile; Trepka, Mary Jo.

In: AIDS Patient Care and Stds, Vol. 32, No. 4, 04.2018, p. 165-173.

Research output: Contribution to journalArticle

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AU - Cosner, Chelsea

AU - Fennie, Kristopher P

AU - Gebrezgi, Merhawi T

AU - Cyrus, Elena

AU - Maddox, Lorene M

AU - Levison, Julie H

AU - Spencer, Emma C

AU - Niyonsenga, Theophile

AU - Trepka, Mary Jo

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N2 - 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.

AB - 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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