Sheehan Diana M, Mauck Daniel E, Fennie Kristopher P, Cyrus Elena A, Maddox Lorene M, Lieb Spencer, Trepka Mary Jo
Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL 33199, USA.
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.
Int J Environ Res Public Health. 2017 Jan 27;14(2):120. doi: 10.3390/ijerph14020120.
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.
该研究的目的是确定2015年拉丁裔人群在接受艾滋病护理和抑制艾滋病毒病毒载量(VL)方面,在感染艾滋病毒、黑人与白人种族以及出生国家方面存在的差异。佛罗里达州对确诊感染艾滋病毒的拉丁裔人群(2000 - 2014年)的监测数据与美国社区调查数据进行了合并。采用多层次(随机效应)模型来估计护理未持续和病毒载量未抑制的调整优势比(aOR)。黑人和白人在护理未持续方面的几率相似。在控制邻里因素后,病毒载量抑制方面的种族差异消失。与在美国出生的拉丁裔相比,出生在墨西哥的拉丁裔(护理持续aOR为2.00,95%置信区间为1.70 - 2.36;病毒载量aOR为1.85,95%置信区间为1.57 - 2.17)以及中美洲出生的拉丁裔(护理持续aOR为1.33,95%置信区间为1.16 - 1.53;病毒载量aOR为1.28,95%置信区间为1.12 - 2.47)在控制个体和邻里因素后风险增加。在中美洲出生的人群中,出生在危地马拉的拉丁裔(护理持续aOR为2.39,95%置信区间为1.80 - 3.18;病毒载量aOR为2.20,95%置信区间为1.66 - 2.92)和洪都拉斯出生的拉丁裔(护理持续aOR为1.39,95%置信区间为1.13 - 1.72;病毒载量aOR为1.42,95%置信区间为1.16 - 1.74)与在美国出生的拉丁裔相比,差异最为显著。拉丁裔人群内部在护理和治疗方面存在差异。拉丁裔黑人与白人种族以及出生国家亚组所特有的文化和其他因素,应进一步研究并考虑用于干预。