title: Risk of opportunistic infection in the HAART era among HIV-infected Latinos born in the United States compared to Latinos born in Mexico and Central America.
abstract: There are few studies that compare opportunistic infection (OI) rates for U.S.-born, Mexican-born, and Central American-born Latinos in the pre- or post-highly active antiretroviral therapy (HAART) era. Data on 803 Latino persons in treatment for HIV infection in Los Angeles, California, were examined to evaluate differences in risk for specific and total OIs by country of origin. In a Cox proportional hazards regression analysis that controlled for HAART use, CD4 counts, and age, U.S.-born Latino women were more likely than Central American-born Latino women to develop an OI from 1996 to 2000 (hazard ratio [HR] = 2.9, 95% confidence intervals [CIs]: 1.3, 6.5). In a Poisson regression analysis, U.S.-born Latino men and women combined were at greater risk for HIV encephalopathy (RR = 3.4, 95% CIs: 1.2, 10.0) and Kaposi's sarcoma (RR = 2.9, 95% CIs: 1.1, 7.6). In addition to underreporting that may result from the use of English-based criteria for diagnosing HIV encephalopathy among Spanish-speaking patients, these HAART era data suggest that variation in OI risk among Latinos may also be explained by acculturation factors, such as loss of social support systems and negative lifestyle changes.
authors.affiliation: HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, California 90005, USA. awohl@dhs.co.la.ca.us
authors.forename: Amy Rock
authors.initials: AR
authors.lastname: Wohl
authors.forename: Sharon
authors.initials: S
authors.lastname: Lu
authors.forename: Jane
authors.initials: J
authors.lastname: Turner
authors.forename: Andrea
authors.initials: A
authors.lastname: Kovacs
authors.forename: Mallory
authors.initials: M
authors.lastname: Witt
authors.forename: Kathleen
authors.initials: K
authors.lastname: Squires
authors.forename: William
authors.initials: W
authors.lastname: Towner
authors.forename: Victor
authors.initials: V
authors.lastname: Beer
mesh_terms: D015526:AIDS Dementia Complex / Q000208:ethnology; D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000208:ethnology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008019:Life Style; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D017058:Mexican Americans; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000208:ethnology; D012307:Risk Factors; D014481:United States