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Individual and Neighborhood Determinants of Late HIV Diagnosis Among Latinos, Florida, 2007–2011

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Abstract

The objective of this study was to examine individual and neighborhood determinants of late HIV diagnosis by gender and birthplace among Latinos. Florida HIV surveillance data for 2007–2011 were merged with American Community Survey data to estimate the odds of late HIV diagnosis (AIDS within 3 months of HIV diagnosis). Of 5522 HIV-positive Latinos, 26.5 % were diagnosed late. The odds ratio (OR) for late diagnosis was 1.39 times higher for males than females [95 % confidence interval (CI) 1.14–1.69]. Neighborhood-level factors associated with late diagnosis included residing in the 3 highest quartiles of neighborhood unemployment for males. The OR was 1.22 times higher for foreign- than US-born Latinos (95 % CI 1.07–1.40). Among foreign-born, residing in areas in the 2nd and 3rd quartiles of unemployment, in rural areas, and areas with <25 % Hispanic/Latino population were associated with late diagnosis. Population-based HIV testing campaigns may require tailoring to ensure that they effectively reach male Latinos in areas with high unemployment and foreign-born Latinos in rural and predominantly non-Latino areas.

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Acknowledgments

Research reported in this publication was supported by the National Institute on Drug Abuse (NIDA) under Award Number F31DA037790 and by the National Institute on Minority Health and Health Disparities (NIMHD) under award 5R01MD004002 of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author Contribution

To our knowledge this is the first study to identify neighborhood-level predictors of late HIV diagnosis for Latinos beyond rural/urban differences. Findings suggest that HIV testing campaigns in areas with high unemployment are not reaching Latino males. Additionally, foreign-born Latinos in rural and predominantly non-Latino areas appear to be at greater risk of late HIV diagnosis.

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Authors and Affiliations

  1. 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

    Diana M. Sheehan & Mary Jo Trepka

  2. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 478, Miami, FL, 33199, USA

    Diana M. Sheehan, Mary Jo Trepka, Kristopher P. Fennie & Purnima Madhivanan

  3. Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136, USA

    Guillermo Prado

  4. Department of Educational and Counseling Psychology, School of Education, University at Albany – State University of New York, 1400 Washington Ave, Albany, NY, 12222, USA

    Frank R. Dillon

  5. HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL, 32399, USA

    Lorene M. Maddox

Authors
  1. Diana M. Sheehan
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  2. Mary Jo Trepka
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  3. Kristopher P. Fennie
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  4. Guillermo Prado
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  5. Purnima Madhivanan
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  6. Frank R. Dillon
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  7. Lorene M. Maddox
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Corresponding author

Correspondence to Mary Jo Trepka.

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Funding

This study was funded by the National Institute on Drug Abuse (NIDA) under Award Number F31DA037790 and by the National Institute on Minority Health & Health Disparities (NIMHD) under award 5R01MD004002 of the National Institutes of Health.

Conflict of interest

DM Sheehan declares no conflicts of interest. MJ Trepka declares no conflicts of interest. KP Fennie declares no conflicts of interest. G Prado declares no conflicts of interest. P Madhivanan declares no conflicts of interest. FR Dillon declares no conflicts of interest. LM Maddox declares no conflicts of interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Florida International University and Florida Department of Health Institutional Review Boards approved this study.

Informed Consent

This study conducted secondary data analysis of de-identified state-level administrative data, and therefore, informed consent was not applicable.

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Sheehan, D.M., Trepka, M.J., Fennie, K.P. et al. Individual and Neighborhood Determinants of Late HIV Diagnosis Among Latinos, Florida, 2007–2011. J Immigrant Minority Health 19, 825–834 (2017). https://doi.org/10.1007/s10903-016-0422-2

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  • DOI: https://doi.org/10.1007/s10903-016-0422-2

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