title: Black-White Latino Racial Disparities in HIV Survival, Florida, 2000-2011.
abstract: This research aimed to estimate Black/White racial disparities in all-cause mortality risk among HIV-positive Latinos. Florida surveillance data for Latinos diagnosed with HIV (2000-2008) were merged with 2007-2011 American Community Survey data. Crude and adjusted hazard ratios (aHR) were calculated using multi-level Cox regression. Of 10,903 HIV-positive Latinos, 8.2% were Black and 91.9% White. Black Latinos were at increased mortality risk compared with White Latinos after controlling for individual and neighborhood factors (aHR 1.40, 95% confidence interval (CI) 1.21-1.62). In stratified analyses, risk factors for Black Latinos included: age ≥60 years compared with ages 13-19 (aHR 4.63, 95% CI 1.32-16.13); US birth compared with foreign birth (aHR 1.56, 95% CI 1.16-2.11); diagnosis of AIDS within three months of HIV diagnosis (aHR 3.53, 95% CI 2.64-4.74); residence in the 3rd (aHR 1.82, 95% CI 1.13-2.94) and 4th highest quartiles (aHR 1.79, 95% CI 1.12-2.86) of neighborhood poverty compared with the lowest quartile; and residence in neighborhood with 25%-49% (aHR 1.59, 95% CI 1.07-2.42) and ≥50% Latinos compared with <25% Latinos (aHR 1.58, 95% CI 1.03-2.42). Significant racial disparities in HIV survival exist among Latinos. Differential access to-and quality of-care and perceived/experienced racial discrimination may be possible explanations.
authors.affiliation: Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA. dshee004@fiu.edu.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Sheehan
authors.affiliation: Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA. trepkam@fiu.edu.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Trepka
authors.affiliation: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA. kfennie@fiu.edu.
authors.forename: Kristopher P
authors.initials: KP
authors.lastname: Fennie
authors.affiliation: Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA. gprado@med.miami.edu.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Prado
authors.affiliation: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA. mcanojr@fiu.edu.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Cano
authors.affiliation: HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399, USA. lorene.maddox@flhealth.gov.
authors.forename: Lorene M
authors.initials: LM
authors.lastname: Maddox
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida / Q000208:ethnology; D015658:HIV Infections / Q000208:ethnology* / Q000401:mortality*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Latinos; human immunodeficiency virus; mortality; neighborhood; racial disparities