title: Racial/ethnic disparities in delayed HIV diagnosis among men who have sex with men, Florida, 2000-2014.
abstract: Only about 85% of men who have sex with men (MSM) with human immunodeficiency virus (HIV) have been tested for and diagnosed with HIV. Racial/ethnic disparities in HIV risk and HIV care outcomes exist within MSM. We examined racial/ethnic disparities in delayed HIV diagnosis among MSM. Males aged ≥13 reported to the Florida Enhanced HIV/AIDS Reporting System 2000-2014 with a reported HIV transmission mode of MSM were analyzed. We defined delayed HIV diagnosis as an AIDS diagnosis within three months of the HIV diagnosis. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR). Of 39,301 MSM, 27% were diagnosed late. After controlling for individual factors, neighborhood socioeconomic status, and rural-urban residence, non-Latino Black MSM had higher odds of delayed diagnosis compared with non-Latino White MSM (aOR 1.15, 95% confidence interval [CI] 1.08-1.23). Foreign birth compared with US birth was a risk factor for Black MSM (aOR 1.27, 95% CI 1.12-1.44), but a protective factor for White MSM (aOR 0.77, 95% CI 0.68-0.87). Rural residence was a risk for Black MSM (aOR 1.79, 95% CI 1.36-2.35) and Latino MSM (aOR 1.87, 95% CI 1.24-2.84), but not for White MSM (aOR 1.26, 95% CI 0.99-1.60). HIV testing barriers particularly affect non-Latino Black MSM. Social and/or structural barriers to testing in rural communities may be significantly contributing to delayed HIV diagnosis among minority MSM.
authors.affiliation: a Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University , Miami , FL , USA.|b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , 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 , Miami , FL , USA.|b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , 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 , Miami , FL , USA.
authors.forename: Kristopher P
authors.initials: KP
authors.lastname: Fennie
authors.affiliation: c Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , FL , USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Prado
authors.affiliation: b Department of Epidemiology, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , FL , USA.
authors.forename: Gladys
authors.initials: G
authors.lastname: Ibanez
authors.affiliation: d Florida Department of Health , HIV/AIDS Section , Tallahassee , FL , USA.
authors.forename: Lorene M
authors.initials: LM
authors.lastname: Maddox
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005006:Ethnicity; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D054625:Healthcare Disparities; D018451:Homosexuality, Male; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012424:Rural Population; D055815:Young Adult
keywords: Human immunodeficiency virus; late diagnosis; men who have sex with men; neighborhood