HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sampling
2.2. Data Collection and Classification
2.3. Sociodemographic and Behavioral Characteristics
2.4. HIV Care and Clinical Outcome Measures
2.5. Analysis
3. Results
3.1. Sociodemographic, Behavioral and Clinical Characteristics
3.2. HIV Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Mainland-US-Born | Puerto Rico-Born | Non-US-Born | |||
---|---|---|---|---|---|---|
n | Weighted Column % | n | Weighted Column % | n | Weighted Column % | |
(95% CI) | (95% CI) | (95% CI) | ||||
Total | 944 | 39.8 (33.2–46.4) | 634 | 21.9 (8.8–35.0) | 986 | 38.3 (31.0–45.5) |
Currently reside in Puerto Rico | - | - | 435 | 66.6 (40.6–92.7) | - | - |
Gender | ||||||
Male | 721 | 80.9 (78.0–83.7) | 411 | 70.6 (66.6–74.6) | 776 | 81.8 (79.0–84.7) |
Female | 205 | 19.1 (16.3–22.0) | 212 | 29.4 (25.4–33.4) | 185 | 18.2 (15.3–21.0) |
Age (Years) | ||||||
18–34 | 254 | 27.0 (23.5–30.5) | 51 | 7.2 (5.1–9.2) | 131 | 13.1 (10.4–15.7) |
35–44 | 181 | 21.9 (18.4–25.5) | 96 | 16.0 (12.9–19.1) | 265 | 28.2 (24.7–31.7) |
45–54 | 283 | 28.7 (25.2–32.3) | 229 | 37.5 (34.4–40.6) | 366 | 36.5 (33.2–39.9) |
≥55 | 226 | 22.4 (19.2–25.5) | 258 | 39.3 (35.1–43.4) | 224 | 22.2 (19.1–25.3) |
Education | ||||||
<High school | 181 | 16.8 (14.1–19.5) | 184 | 29.2 (25.0–33.3) | 341 | 35.2 (31.9–38.6) |
High school diploma or equivalent | 244 | 25.4 (21.9–28.8) | 164 | 26.8 (22.3–31.3) | 225 | 22.8 (19.9–25.7) |
>High school | 518 | 57.8 (53.7–61.9) | 285 | 44.0 (39.5–48.5) | 415 | 42.0 (38.1–45.9) |
At or below federal poverty level | 373 | 39.7 (35.8–43.6) | 412 | 66.2 (62.0–70.4) | 448 | 47.9 (44.1–51.8) |
Speaks language other than English at home | 532 | 56.3 (52.0–60.6) | 607 | 96.6 (93.8–99.4) | 875 | 88.9 (86.2–91.6) |
Speaks English well or very well | 924 | 98.1 (97.0–99.2) | 334 | 53.2 (40.8–65.6) | 628 | 64.2 (60.2–67.9) |
Received care at a Ryan White HIV/AIDS Program-funded facility a,b | 631 | 68.9 (64.5–73.4) | 584 | 91.0 (83.6–98.5) | 742 | 77.8 (73.4–82.3) |
Had any Ryan White coverage c | 402 | 40.4 (36.2–44.7) | 257 | 43.7 (37.1–50.3) | 603 | 62.9 (58.9–66.9) |
Country of birth | ||||||
Caribbean | - | - | - | - | 153 | 15.4 (12.1–18.7) |
Central America | - | - | - | - | 177 | 17.1 (14.2–20.0) |
Mexico | - | - | - | - | 474 | 48.6 (43.6–53.6) |
South America | - | - | - | - | 157 | 16.2 (13.2–19.2) |
Others | - | - | - | - | 24 | 2.7 (1.3–4.0) |
Age at migration (Years) | ||||||
<18 | - | - | - | - | 231 | 24.2 (21.1–27.4) |
≥18 | - | - | - | - | 750 | 75.8 (72.6–78.9) |
Time living in the United States (Years) | ||||||
<5 | - | - | - | - | 44 | 5.1 (3.2–6.9) |
5–9 | - | - | - | - | 51 | 4.2 (3.0–5.5) |
≥10 | - | - | - | - | 886 | 90.7 (88.6–92.8) |
Date of diagnosis relative to immigration | ||||||
≥5 years before arrival | - | - | - | - | 51 | 5.1 (3.5–6.6) |
1–4 years before arrival | - | - | - | - | 44 | 4.7 (3.1–6.3) |
Same year as arrival | - | - | - | - | 42 | 5.0 (3.4–6.7) |
1–4 years after arrival | - | - | - | - | 136 | 13.7 (11.3–16.1) |
5–9 years after arrival | - | - | - | - | 191 | 19.0 (16.1–21.8) |
≥10 years after arrival | - | - | - | - | 516 | 52.5 (49.0–56.1) |
Weighted Row % (95% CI) | Prevalence Ratio (95% CI) | p-Value a | |
---|---|---|---|
Gender (Male) | |||
Mainland-US-born | 80.9 (78.0–83.7) | Ref. | -- |
Puerto Rico-born | 70.6 (66.6–74.6) | 0.87 (0.82–0.93) | <0.0001 |
Non-US-born | 81.8 (79.0–84.7) | 1.01 (0.96–1.06) | 0.641 |
Age (18–44 Years) | |||
Mainland-US-born | 48.9 (44.9–53.0) | Ref. | - |
Puerto Rico-born | 23.2 (19.8–26.6) | 0.47 (0.40–0.56) | <0.0001 |
Non-US-born | 41.3 (37.5–45.0) | 0.84 (0.75–0.95) | 0.0064 |
Education (<High school) | |||
Mainland-US-born | 16.8 (14.1–19.5) | Ref. | - |
Puerto Rico-born | 29.2 (25.0–33.3) | 1.74 (1.41–2.14) | <0.0001 |
Non-US-born | 35.2 (31.9–38.6) | 2.10 (1.74–2.53) | <0.0001 |
At or below federal poverty level | |||
Mainland-US-born | 39.7 (35.8–43.6) | Ref. | - |
Puerto Rico-born | 66.2 (62.0–70.4) | 1.67 (1.49–1.87) | <0.0001 |
Non-US-born | 47.9 (44.1–51.8) | 1.21 (1.07–1.36) | 0.0022 |
Speaks language other than English at home | |||
Mainland-US-born | 56.3 (52.0–60.6) | Ref. | - |
Puerto Rico-born | 96.6 (93.8–99.4) | 1.72 (1.60–1.84) | <0.0001 |
Non-US-born | 88.9 (86.2–91.6) | 1.58 (1.46–1.71) | <0.0001 |
Speaks English well or very well | |||
Mainland-US-born | 98.1 (97.0–99.2) | Ref. | - |
Puerto Rico-born | 53.2 (40.8–65.6) | 0.54 (0.43–0.68) | <0.0001 |
Non-US-born | 64.2 (60.5–67.9) | 0.65 (0.62–0.69) | <0.0001 |
Received care at a Ryan White HIV/AIDS Program-funded facility b,c | |||
Mainland-US-born | 68.9 (64.5–73.4) | Ref. | -- |
Puerto Rico-born | 91.0 (83.6–98.5) | 1.30 (1.19–1.41) | <0.0001 |
Non-US-born | 77.8 (73.4–82.3) | 1.11 (1.05–1.19) | 0.0008 |
Had any Ryan White coverage d | |||
Mainland-US-born | 40.4 (36.2–44.7) | Ref. | - |
Puerto Rico-born | 43.7 (37.1–50.3) | 1.06 (0.89–1.27) | 0.5296 |
Non-US-born | 62.9 (58.9–66.9) | 1.57 (1.41–1.74) | <0.0001 |
Binge drinking, past 30 days e | |||
Mainland-US-born | 21.9 (18.5–25.2) | Ref. | -- |
Puerto Rico-born | 18.9 (8.7–29.2) | 0.87 (0.49–1.52) | 0.5886 |
Non-US-born | 15.7 (13.2–18.3) | 0.72 (0.58–0.90) | 0.0041 |
Non-injection drug use | |||
Mainland-US-born | 37.4 (33.3–41.4) | Ref. | - |
Puerto Rico-born | 17.7 (14.7–20.7) | 0.47 (0.39–0.58) | <0.0001 |
Non-US-born | 14.2 (11.6–16.7) | 0.38 (0.31–0.47) | <0.0001 |
Injection drug use | |||
Mainland-US-born | 4.3 (2.5–6.1) | Ref. | - |
Puerto Rico-born | 1.5 (0.7–2.3) | 0.35 (0.18–0.70) | 0.0066 |
Non-US-born f | - | - | - |
Major or other depression, past 2 weeks g | |||
Mainland-US-born | 27.6 (24.0–31.2) | Ref. | - |
Puerto Rico-born | 22.2 (18.5–25.9) | 0.80 (0.66–0.98) | 0.0521 |
Non-US-born | 16.9 (14.1–19.8) | 0.61 (0.49–0.76) | <0.0001 |
Moderate to severe anxiety, past 2 weeks h | |||
Mainland-US-born | 20.7 (17.5–24.0) | Ref. | - |
Puerto Rico-born | 19.1 (16.6–21.6) | 0.92 (0.75–1.13) | 0.4509 |
Non-US-born | 11.2 (8.9–13.5) | 0.54 (0.42–0.70) | <0.0001 |
Stage 3 classification (AIDS) | |||
Mainland-US-born | 50.6 (46.5–54.7) | Ref. | -- |
Puerto Rico-born | 56.5 (52.2–60.8) | 1.12 (1.00–1.24) | 0.0352 |
Non-US-born | 58.5 (54.8–62.1) | 1.16 (1.04–1.28) | 0.0056 |
Weighted Row % (95% CI) | Prevalence Ratio (95% CI) | p-Value a | |
---|---|---|---|
ART prescription | |||
Mainland-US-born | 78.6 (74.5–82.6) | Ref. | - |
Puerto Rico-born | 94.0 (91.8–96.2) | 1.20 (1.13–1.26) | <0.0001 |
Non-US-born | 90.9 (88.4–93.4) | 1.16 (1.09–1.23) | <0.0001 |
100% adherent to ART doses, past 30 days b,c | |||
Mainland-US-born | 38.6 (34.5–42.7) | Ref. | - |
Puerto Rico-born | 41.5 (36.2–46.9) | 1.08 (0.91–1.27) | 0.37 |
Non-US-born | 44.7 (41.0–48.3) | 1.16 (1.01–1.33) | 0.03 |
Retention in care d | |||
Mainland-US-born | 77.3 (73.1–81.4) | Ref. | - |
Puerto Rico-born | 94.3 (90.8–97.8) | 1.22 (1.15–1.30) | <0.0001 |
Non-US-born | 87.3 (84.5–90.1) | 1.13 (1.06–1.20) | <0.0001 |
Recent viral suppression e | |||
Mainland-US-born | 65.1 (60.8–69.4) | Ref. | - |
Puerto Rico-born | 84.6 (80.8–88.5) | 1.30 (1.20–1.40) | <0.0001 |
Non-US-born | 80.1 (76.8–83.4) | 1.23 (1.14–1.32) | <0.0001 |
Sustained viral suppression f | |||
Mainland-US-born | 57.3 (53.1–61.5) | Ref. | - |
Puerto Rico-born | 74.6 (70.5–78.8) | 1.30 (1.19–1.42) | <0.0001 |
Non-US-born | 73.8 (70.4–77.2) | 1.29 (1.18–1.40) | <0.0001 |
Characteristics | Reside in PR (n = 435) | Reside in Mainland US (n = 199) | p-Value | ||
---|---|---|---|---|---|
n | Weighted Row % (95% CI) | n | Weighted Row % (95% CI) | ||
ART prescription | 419 | 95.5 (94.8–96.2) | 184 | 91.0 (85.5–96.4) | 0.0066 |
100% adherent to ART doses, past 30 days a | 170 | 42.4 (35.8–49.0) | 78 | 39.7 (31.9–47.5) | 0.5902 |
Retention in care b | 424 | 97.2 (95.2–99.1) | 178 | 88.4 (82.1–94.7) | 0.0192 |
Recent viral suppression c | 381 | 87.9 (85.1–90.6) | 158 | 78.1 (71.0–85.2) | <0.0001 |
Sustained viral suppression d | 335 | 78.2 (75.4–80.9) | 136 | 67.6 (60.1–75.0) | <0.0001 |
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Demeke, H.B.; Luo, Q.; Luna-Gierke, R.E.; Padilla, M.; Girona-Lozada, G.; Miranda-De León, S.; Weiser, J.; Beer, L. HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project. Int. J. Environ. Res. Public Health 2020, 17, 171. https://doi.org/10.3390/ijerph17010171
Demeke HB, Luo Q, Luna-Gierke RE, Padilla M, Girona-Lozada G, Miranda-De León S, Weiser J, Beer L. HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project. International Journal of Environmental Research and Public Health. 2020; 17(1):171. https://doi.org/10.3390/ijerph17010171
Chicago/Turabian StyleDemeke, Hanna B., Qingwei Luo, Ruth E. Luna-Gierke, Mabel Padilla, Gladys Girona-Lozada, Sandra Miranda-De León, John Weiser, and Linda Beer. 2020. "HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project" International Journal of Environmental Research and Public Health 17, no. 1: 171. https://doi.org/10.3390/ijerph17010171
APA StyleDemeke, H. B., Luo, Q., Luna-Gierke, R. E., Padilla, M., Girona-Lozada, G., Miranda-De León, S., Weiser, J., & Beer, L. (2020). HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project. International Journal of Environmental Research and Public Health, 17(1), 171. https://doi.org/10.3390/ijerph17010171