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Racial Differences in Social Determinants of Health and Outcomes Among Hispanic/Latino Persons with HIV—United States, 2015–2020

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Abstract

Background

Hispanic/Latino people with HIV (PWH) experience disparities in health outcomes compared with other racial and ethnic groups. Disaggregated data based on race for Hispanic/Latino PWH in the United States are rarely reported, potentially masking inequities.

Methods

The Medical Monitoring Project (MMP) is a complex sample survey of adults with diagnosed HIV. We used weighted interview and medical record data collected from June 2015–May 2021 to examine differences in social determinants of health (SDH) and health outcomes by self-reported race among Hispanic/Latino adults with diagnosed HIV.

Results

Compared with White Hispanic/Latino PWH, Black Hispanic/Latino PWH were more likely to be unemployed (PR, 1.4; CI, 1.2–1.8), have a disability (PR, 1.3; CI, 1.2–1.5), have experienced homelessness (PR, 1.8; CI, 1.2–2.6), and have been incarcerated (PR, 2.6; CI, 1.5–4.5). American Indian/Alaska Native (AI/AN) (PR, 1.8; CI, 1.1–2.7) and multiracial (PR, 2.0; CI, 1.4–2.9) Hispanic/Latino PWH were more likely to have experienced homelessness than White Hispanic/Latino PWH. Black (PR, 1.3; CI, 1.2–1.5) and multiracial (PR, 1.2; CI, 1.1–1.5) Hispanic/Latino PWH were more likely to be virally unsuppressed than White Hispanic/Latino PWH.

Conclusion

Black, multiracial, and AI/AN Hispanic/Latino PWH experience disparities in SDH and HIV outcomes. Lumping Hispanic/Latino people into one racial and ethnic category obscures health disparities, which might limit our progress towards reaching national HIV goals. Future studies should consider disaggregating by other factors such as Hispanic origin, place of birth, immigration status, and primary language. Doing so recognizes the diversity of the Hispanic/Latino population.

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Data Availability

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Acknowledgements

The authors thank MMP participants, project area staff, and MMP provider and community advisory board members. We also acknowledge the contributions of the Clinical Outcomes Team and Behavioral and Clinical Surveillance Branch at CDC.

Funding

Funding for the Medical Monitoring Project is provided by the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Mabel Padilla, Ruth E. Luna-Gierke, Mariana Gutierrez & Sharoda Dasgupta

  2. DHAP/NCHHSTP/CDC, 1600 Clifton Road NE MS E-46, Atlanta, GA, 30333, USA

    Mabel Padilla

  3. DLH Corporation, Atlanta, GA, USA

    Tamara Carree & Xin Yuan

Authors
  1. Mabel Padilla
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  2. Ruth E. Luna-Gierke
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  3. Tamara Carree
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  4. Mariana Gutierrez
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  5. Xin Yuan
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  6. Sharoda Dasgupta
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Contributions

All authors made substantial contributions to the analysis and interpretation of the data, revised the manuscript critically, approved the version to be published, and are accountable for all aspects of the work. Data analysis was performed by Tamara Carree and Xin Yuan. Data interpretation was performed by Mabel Padilla, Ruth E. Luna-Gierke, Mariana Gutierrez and Sharoda Dasgupta. The first draft of the manuscript was written by Mabel Padilla and all authors substantially commented on prior iterations of the manuscript.

Corresponding author

Correspondence to Mabel Padilla.

Ethics declarations

Ethics Approval

MMP data collection is part of routine public health surveillance and was determined to be non-research.

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Informed consent was obtained for all participants.

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Conflicts of Interest

The authors declare no conflicts of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Padilla, M., Luna-Gierke, R.E., Carree, T. et al. Racial Differences in Social Determinants of Health and Outcomes Among Hispanic/Latino Persons with HIV—United States, 2015–2020. J. Racial and Ethnic Health Disparities 11, 574–588 (2024). https://doi.org/10.1007/s40615-023-01542-4

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