Lindan C P, Hearst N, Singleton J A, Trachtenberg A I, Riordan N M, Tokagawa D A, Chu G S
Center for AIDS Prevention Studies (CAPS), University of California, San Francisco.
Public Health Rep. 1990 Jul-Aug;105(4):400-4.
A disproportionately high number of AIDS cases in the United States involve members of racial minorities. Even so, AIDS deaths of minority members may be undercounted. The completeness of reporting of AIDS deaths to the California AIDS Registry (ARS) among Hispanics, blacks, and whites in 1985 and 1986 from the San Francisco Bay Area was investigated. Death certificates listing AIDS as a cause of death or associated condition were identified and cross-checked with cases reported to ARS, current to December 1988. Death certificates were checked by hand for racial or ethnic classification using a definition of Hispanic based on information available on certificates. Three causes of undercounting in ARS were identified: a death was not reported as an AIDS case at all, an AIDS case was reported to ARS but the person was listed as still living, or an AIDS death was reported to ARS with a different racial or ethnic classification. The proportion of cases not reported at all was similar for all three racial-ethnic groups (5-8 percent). The proportion of deaths reported for persons listed in the registry as still living was 12 percent for Hispanics and 9 percent for blacks, compared with 5 percent for whites. For Hispanics, under-counting was largely due to ethnic misclassification. Twenty percent of Hispanics had been counted as white in the AIDS registry. In comparison, 4 percent of blacks and 1 percent of whites were misclassified by race. AIDS deaths among blacks and Hispanics may be undercounted, even in an area with good AIDS surveillance systems. This suggests that overrepresentation of minorities among AIDS cases in the United States may be even greater than indicated by current reporting data.
美国艾滋病病例中，少数族裔成员所占比例过高。即便如此，少数族裔成员的艾滋病死亡人数可能仍被低估。对1985年和1986年旧金山湾区西班牙裔、黑人和白人向加利福尼亚艾滋病登记处（ARS）报告艾滋病死亡情况的完整性进行了调查。找出将艾滋病列为死亡原因或相关病症的死亡证明，并与截至1988年12月向ARS报告的病例进行交叉核对。根据死亡证明上的现有信息，使用西班牙裔的定义，人工检查死亡证明的种族或族裔分类。确定了ARS中漏报的三个原因：死亡根本未被报告为艾滋病病例；艾滋病病例已报告给ARS，但该人被列为仍然在世；艾滋病死亡报告给ARS时种族或族裔分类有误。所有三个种族-族裔群体中完全未报告的病例比例相似（5%-8%）。登记处中列为仍然在世的人报告的死亡比例，西班牙裔为12%，黑人为9%，而白人为5%。对西班牙裔来说，漏报主要是由于种族错误分类。20%的西班牙裔在艾滋病登记处被计为白人。相比之下，4%的黑人及1%的白人存在种族错误分类。即使在艾滋病监测系统良好的地区，黑人和西班牙裔的艾滋病死亡人数也可能被低估。这表明美国艾滋病病例中少数族裔的占比过高情况可能比目前报告数据所显示的还要严重。
