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Delayed Diagnosis of Human Immunodeficiency Virus in the Latino Population at a Federally Qualified Community Health Center in New Jersey

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Late diagnosis of human immunodeficiency virus (HIV) is associated with early progression to acquired immunodeficiency syndrome (AIDS). We examined racial/ethnic differences in presentation with advanced HIV/AIDS at a community health center in New Jersey. Records of patients diagnosed with HIV between 1990 and 2018 were reviewed. Odds ratios (OR) of presenting with AIDS at HIV diagnosis were computed in unadjusted and adjusted models. There were 182 (48.3%) Latino, 48 (12.7%) non-Latino White (NLW), 130 (34.5%) non-Latino Black, and 17 (4.5%) non-Latino of other race/ethnicity included in the analysis. Over 75% of the Latinos were foreign-born. Latino patients had higher odds of presentation with AIDS at time of HIV diagnosis than NLW in unadjusted (OR = 4.85, 95% confidence interval (95% CI): 2.28–10.31) and adjusted models (OR = 3.71, 95%CI: 1.60–8.59). Latino patients, particularly foreign-born and bisexual, had higher odds of being diagnosed with AIDS at presentation with HIV in this cohort.

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  1. Centers for Disease Control and Prevention. HIV Testing | HIV/AIDS. HIV Testing | HIV/AIDS. 2020.

  2. United States Census Bureau. U.S. Census Bureau QuickFacts: United States. https://www.censusgov/quickfacts/fact/table/US/RHI725219.

  3. Hogg RS. Rates of Disease Progression by Baseline CD4 cell count and viral load after initiating Triple-Drug Therapy. JAMA. 2001;286(20):2568.

    Article  CAS  PubMed  Google Scholar 

  4. Dennis AM, Napravnik S, Sena AC, Eron JJ. Late entry to HIV Care among Latinos compared with Non-Latinos in a Southeastern US Cohort. Clin Infect Dis. 2011;53(5):480–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Morales-Aleman MM, Sutton MY. Hispanics/Latinos and the HIV continuum of care in the Southern USA: a qualitative review of the literature, 2002–2013. AIDS Care. 2014;26(12):1592–604.

    Article  PubMed  Google Scholar 

  6. Centers for Disease Control and Prevention. Late HIV Testing – 34 States, 1996–2005. https://www.cdcgov/mmwr/preview/mmwrhtml/mm5824a2htm/. 2009.

  7. Chen NE, Gallant JE, Page KR. A systematic review of HIV/AIDS survival and delayed diagnosis among Hispanics in the United States. J Immigr Minor Health. 2012;14(1):65–81.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gindi RM, Erbelding EJ, Page KR. Sexually transmitted infection prevalence and behavioral risk factors among latino and non-latino patients attending the Baltimore City STD clinics. J Sex Transm Dis. 2010;37(3):191–6.

    Article  Google Scholar 

  9. Linley L, Prejean J, An Q, Chen M, Hall HI. Racial/ethnic disparities in HIV diagnoses among persons aged 50 years and older in 37 US States, 2005–2008. Am J Public Health. 2012;102(8):1527–34.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Meyer MA, Champion JD. Protective factors for HIV infection among mexican american men who have sex with men. J Assoc Nurses AIDS Care. 2010;21(1):53–62.

    Article  PubMed  Google Scholar 

  11. Ross J, Hanna DB, Felsen UR, Cunningham CO, Patel VV. Emerging from the database shadows: characterizing undocumented immigrants in a large cohort of HIV-infected persons. AIDS Care. 2017;29(12):1491–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Pew Research Center. Latinos in California, Texas, New York, Florida and New Jersey. 2004. https://www.pewresearchorg/hispanic/2004/03/19/latinos-in-california-texas-new-york-florida-and-new-jersey/.

  13. New Jersey State Data Center. Population by Race and Hispanic or Latino Origin | New Jersey and Selected Municipalities: 1980, 1990. and 2000. https://www.njgov/labor/labormarketinformation/assets/PDFs/census/2kpub/njsdcp2pdf.

  14. New Jersey Department of Health. HIV: County and Municipal HIV/AIDS Statistics., 2021. https://www.statenjus/health/hivstdtb/hiv-aids/statmapshtml.

  15. Castro KG, Ward JW, Slutsker L, Buehler JW, Jaffe HW, Berkelman RL, et al. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Clin Infect Dis. 1993;17(4):802–10.

    Article  Google Scholar 

  16. World Health. Organization. ICD-10: international statistical classification of diseases and related health problems: tenth revision. 2nd ed. ed. Geneva: World Health Organization; 2004.

    Google Scholar 

  17. Tseng A, Seet J, Phillips EJ. The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future. Br J Clin Pharmacol. 2015;79(2):182–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Dennis AM, Wheeler JB, Valera E, Hightow-Weidman L, Napravnik S, Swygard H, et al. HIV risk behaviors and sociodemographic features of HIV-infected Latinos residing in a new latino settlement area in the Southeastern United States. AIDS Care. 2013;25(10):1298–307.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Poon KK, Dang BN, Davila JA, Hartman C, Giordano TP. Treatment outcomes in undocumented hispanic immigrants with HIV infection. PLoS ONE. 2013;8(3):e60022.

    Article  CAS  PubMed  PubMed Central  ADS  Google Scholar 

  20. Rodriguez-Diaz CE, Martinez O, Bland S, Crowley JS. Ending the HIV epidemic in US Latinx sexual and gender minorities. J Lancet. 2021;397(10279):1043–5.

    Article  Google Scholar 

  21. Rajabiun S, Rumptz MH, Felizzola J, Frye A, Relf M, Yu G, et al. The impact of acculturation on Latinos’ perceived barriers to HIV primary care. Ethn Dis. 2008;18(4):403–8.

    PubMed  Google Scholar 

  22. Ojikutu BO, Mazzola E, Fullem A, Vega R, Landers S, Gelman RS, et al. HIV Testing among Black and hispanic immigrants in the United States. AIDS Patient Care STDS. 2016;30(7):307–14.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chen NE, Meyer JP, Bollinger R, Page KR. HIV testing behaviors among Latinos in Baltimore City. J Immigr Minor Health. 2012;14(4):540–51.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Yamanis TJ, del Río-González AM, Rapoport L, Norton C, Little C, Barker SL, Ornelas IJ. Understanding fear of deportation and its impact on healthcare access among immigrant latinx men who have sex with men. Sex Gend Minor Health. 2021;21:101–31.

    Google Scholar 

  25. Sheehan DM, Trepka MJ, Dillon FR. Latinos in the United States on the HIV/AIDS care continuum by birth country/region: a systematic review of the literature. Int J STD AIDS. 2015;26(1):1–12.

    Article  PubMed  Google Scholar 

  26. Sheehan DM, Trepka MJ, Fennie KP, Prado G, Madhivanan P, Dillon FR, et al. Individual and Neighborhood determinants of late HIV diagnosis among Latinos, Florida, 2007–2011. J Immigr Minor Health. 2017;19(4):825–34.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Barrington C, Gandhi A, Gill A, Villa Torres L, Brietzke MP, Hightow-Weidman L. Social networks, migration, and HIV testing among Latinos in a new immigrant destination: insights from a qualitative study. Glob Public Health. 2018;13(10):1507–19.

    Article  PubMed  Google Scholar 

  28. Eholié SP, Badje A, Kouame GM, N’Takpe J-B, Moh R, Danel C et al. Antiretroviral treatment regardless of CD4 count: the universal answer to a contextual question. AIDS Res Ther 2016; 13(1).

  29. Witzig R. The medicalization of race: scientific legitimization of a flawed social construct. Ann Intern Med. 1996;125(8):675–9.

    Article  CAS  PubMed  Google Scholar 

  30. Galanti G-A. The hispanic family and male-female relationships: an overview. J Transcult Nurs. 2003;14(3):180–5.

    Article  PubMed  Google Scholar 

  31. Singh S, Song R, Johnson AS, McCray E, Hall HI. HIV incidence, prevalence, and undiagnosed infections in U.S. Men who have sex with men. Ann Intern Med. 2018;168(10):685–94.

    Article  PubMed  Google Scholar 

  32. Nduaguba SO, Ford KH, Wilson JP, Lawson KA, Cook RL. Identifying subgroups within at-risk populations that drive late HIV diagnosis in a Southern U.S. state. Int J STD AIDS. 2021;32(2):162–9.

    Article  CAS  PubMed  Google Scholar 

  33. Mancini MA, Salas-Wright CP, Vaughn MG. Drug use and service utilization among Hispanics in the United States. Soc Psychiatry Psychiatr Epidemiol. 2015;50(11):1679–89.

    Article  PubMed  Google Scholar 

  34. Horridge DN, Oh TS, Alonzo J, Mann-Jackson L, Tanner AE, Song EY et al. Barriers to HIV Testing within a sample of spanish-speaking Latinx Gay, Bisexual, and other men who have sex with men: implications for HIV Prevention and Care. Health Behav Res 2019; 2(3).

  35. Bonacci RA, Holtgrave DR. Unmet HIV Service needs among hispanic men who have sex with men in the United States. AIDS Behav. 2016;20(10):2444–51.

    Article  PubMed  Google Scholar 

  36. Hulgan T, Raffanti S, Kheshti A, Blackwell RB, Rebeiro PF, Barkanic G, et al. CD4 lymphocyte percentage predicts disease progression in HIV-infected patients initiating highly active antiretroviral therapy with CD4 lymphocyte counts > 350 lymphocytes/mm3. J Infect Dis. 2005;192(6):950–7.

    Article  PubMed  Google Scholar 

  37. Williams LD, Tempalski B, Hall HI, Johnson AS, Wang G, Friedman SR. Trajectories of and disparities in HIV prevalence among Black, White, and Hispanic/Latino high risk heterosexuals in 89 U.S. Metropolitan statistical areas, 1992–2013. Ann Epidemiol. 2021;64:140–8.

    Article  PubMed  PubMed Central  Google Scholar 

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We thank staff members at the community health center where this research took place for their assistance with data collection, particularly Cindy Leon-Rosado, MPH and Michele Hawkins-Nunn, RN.

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Correspondence to Sneha Jacob MD.

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D’Costa, Z.U., Neibart, S.S., Jones, L.E. et al. Delayed Diagnosis of Human Immunodeficiency Virus in the Latino Population at a Federally Qualified Community Health Center in New Jersey. J Immigrant Minority Health 26, 294–303 (2024).

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