title: Neighborhood Latino ethnic density and mortality among HIV-positive Latinos by birth country/region, Florida, 2005-2008.
abstract: OBJECTIVE
  Lower mortality for Latinos has been reported in high Latino density areas. The objective was to examine the contribution of neighborhood Latino density to mortality among HIV-positive Latinos.
  
  
  METHODS
  Florida HIV surveillance data for 2005-2008 were merged with the 2007-2011 American Community Survey data using zip code tabulation areas. Hazard ratios (HR) were calculated using multi-level weighted Cox regression and adjusted for individual-level factors and neighborhood poverty.
  
  
  RESULTS
  Of 4649 HIV-positive Latinos, 11.8% died. There was no difference in mortality risk across categories of Latino ethnic density for Latinos as a whole. There were subgroup effects wherein mortality risk differed by ethnic density category for Latinos born in some countries/regions. Residing in an area with ≥50% Latinos compared with <25% was associated with increased mortality risk for Latinos born in Puerto Rico (HR 1.67; 95% confidence interval [CI] [1.01-2.70]). Residing in an area where Mexicans were the majority Latino group was associated with increased mortality risk for Latinos born in Mexico (HR 3.57; 95% CI [1.43-10.00]).
  
  
  CONCLUSIONS
  The survival advantage seen among the Latino population in high Latino density areas was not seen among HIV-positive Latinos. Research is needed to determine if this may be related to stigma or another mechanism.
authors.affiliation: a 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.|b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , 11200 SW 8th St, Miami , FL 33199 , USA.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Sheehan
authors.affiliation: a 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.|b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , 11200 SW 8th St, Miami , FL 33199 , USA.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Trepka
authors.affiliation: b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , 11200 SW 8th St, Miami , FL 33199 , USA.
authors.forename: Kristopher P
authors.initials: KP
authors.lastname: Fennie
authors.affiliation: c Department of Educational and Counseling Psychology , School of Education, University at Albany - State University of New York , 1400 Washington Ave, Albany , NY 12222 , USA.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Dillon
authors.affiliation: b Department of Epidemiology , Robert Stempel College of Public Health and Social Work, Florida International University , 11200 SW 8th St, Miami , FL 33199 , USA.
authors.forename: Purnima
authors.initials: P
authors.lastname: Madhivanan
authors.affiliation: d HIV/AIDS Section , Florida Department of Health , 4052 Bald Cypress Way, Tallahassee , FL 32399 , USA.
authors.forename: Lorene M
authors.initials: LM
authors.lastname: Maddox
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000208:ethnology* / Q000401:mortality*; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D011203:Poverty; D011647:Puerto Rico / Q000208:ethnology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult
keywords: Latino; ethnic density; human immunodeficiency virus; mortality; neighborhood