Cyrus Elena, Dawson Christyl, Fennie Kristopher P, Sheehan Diana M, Mauck Daniel E, Sanchez Mariana, Maddox Lorene M, Trepka Mary Jo
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, Miami, FL 33199, USA.
Int J Environ Res Public Health. 2017 Mar 9;14(3):285. doi: 10.3390/ijerph14030285.
(1) The study aim was to assess disparities in non-retention in HIV care and non-viral suppression among non-Hispanic Black Caribbean immigrants living with HIV in Florida. (2) We analyzed cases involving individuals, aged ≥13, who met CDC HIV case definition during 2000-2014. Chi square test was used to evaluate differences in non-retention and non-viral suppression by country of origin/race/ethnicity. Multilevel logistic regressions with three referent groups [US-born Blacks, Hispanics, and non-Hispanic Whites (NHWs)] were used to estimate adjusted odds ratios (aOR). (3) Caribbean-born Blacks were less likely to be retained in care or be virally suppressed than US-born Blacks, Hispanics, and NHWs. Bahamians, Haitians, and Trinidadians and Tobagonians had increased odds of non-retention (aOR 3.13, 95% confidence interval [CI] 2.40 -4.10; aOR 1.52, 95% CI 1.40-1.66; aOR 2.30, 95% CI 1.38-3.83), and non-viral suppression (aOR 3.23, 95% CI 2.48-4.21; aOR 1.82, 95% CI 1.68-1.98; aOR 1.76, 95% CI 1.06-2.90) compared with NHWs. (4) Caribbean-born Blacks living with HIV infection are less likely than other racial/ethnic groups to be retained in care and/or achieve viral suppression. Further research is urgently needed to determine social, cultural, and biological factors that contribute to this disparity.
(1) 该研究的目的是评估佛罗里达州感染艾滋病毒的非西班牙裔加勒比黑人移民在艾滋病毒护理中断和病毒未得到抑制方面的差异。(2) 我们分析了2000年至2014年期间涉及年龄≥13岁且符合美国疾病控制与预防中心艾滋病毒病例定义的个人的病例。采用卡方检验来评估按原籍国/种族/民族划分的护理中断和病毒未得到抑制方面的差异。使用具有三个参照组[美国出生的黑人、西班牙裔和非西班牙裔白人（NHW）]的多水平逻辑回归来估计调整后的优势比（aOR）。(3) 加勒比出生的黑人比美国出生的黑人、西班牙裔和非西班牙裔白人更不容易坚持接受护理或实现病毒抑制。与非西班牙裔白人相比，巴哈马人、海地人以及特立尼达和多巴哥人护理中断（aOR 3.13，95%置信区间[CI] 2.40 - 4.10；aOR 1.52，95% CI 1.40 - 1.66；aOR 2.30，95% CI 1.38 - 3.83）和病毒未得到抑制（aOR 3.23，95% CI 2.48 - 4.21；aOR 1.82，95% CI 1.68 - 1.98；aOR 1.76，95% CI 1.06 - 2.90）的几率增加。(4) 感染艾滋病毒的加勒比出生的黑人比其他种族/民族群体更不容易坚持接受护理和/或实现病毒抑制。迫切需要进一步研究以确定导致这种差异的社会、文化和生物学因素。
