Differences in HIV-related hospitalization trends between Haitian-born blacks and US-born blacks.
OBJECTIVE
To examine the HIV care needs and hospital admission patterns of HIV-positive Haitian-born blacks (Haitians) and compare them with those of US-born blacks (Blacks).


METHODS
We abstracted the medical records of 635 Blacks and Haitians consecutively admitted to the adult HIV Service at Jackson Memorial Hospital during 2004 for information on demographics, use of antiretroviral therapy, CD4 cell counts, primary and secondary diagnoses at admission, and substance use. The probability of being prescribed highly active antiretroviral therapy (HAART) was examined by country of origin.


RESULTS
There was no statistically significant difference between the groups in likelihood to be prescribed HAART. In controlled analyses, however, Haitians were 76% more likely than Blacks to have a CD4 count <51 cells/mm3 and tended to be more recently diagnosed with HIV Moreover, tuberculosis was the most prevalent opportunistic infection for Haitians compared with candidiasis for Blacks.


CONCLUSIONS
Findings suggest that barriers to medical care may exist for Haitians at an early stage of the access continuum and that prevention efforts among the Haitian HIV-positive population should be directed at promoting the need for timely use of health services.
Rodriguez
Allan E
AE
Division of Infectious Diseases, Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL 33136, USA. arodriguez2@med.miami.edu
Metsch
Lisa R
LR
Saint-Jean
Gilbert
G
Molina
Enrique G
EG
Kolber
Michael A
MA
D017088:AIDS-Related Opportunistic Infections / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D044383:Black People; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data; D002177:Candidiasis / Q000209:etiology; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D014376:Tuberculosis / Q000209:etiology; D001741:Black or African American
D019380:Anti-HIV Agents