Disparity in Retention in Care and Viral Suppression for Black Caribbean-Born Immigrants Living with HIV in Florida

Int J Environ Res Public Health. 2017 Mar 9;14(3):285. doi: 10.3390/ijerph14030285.

Abstract

(1) The study aim was to assess disparities in non-retention in HIV care and non-viral suppression among non-Hispanic Black Caribbean immigrants living with HIV in Florida. (2) We analyzed cases involving individuals, aged ≥13, who met CDC HIV case definition during 2000-2014. Chi square test was used to evaluate differences in non-retention and non-viral suppression by country of origin/race/ethnicity. Multilevel logistic regressions with three referent groups [US-born Blacks, Hispanics, and non-Hispanic Whites (NHWs)] were used to estimate adjusted odds ratios (aOR). (3) Caribbean-born Blacks were less likely to be retained in care or be virally suppressed than US-born Blacks, Hispanics, and NHWs. Bahamians, Haitians, and Trinidadians and Tobagonians had increased odds of non-retention (aOR 3.13, 95% confidence interval [CI] 2.40 -4.10; aOR 1.52, 95% CI 1.40-1.66; aOR 2.30, 95% CI 1.38-3.83), and non-viral suppression (aOR 3.23, 95% CI 2.48-4.21; aOR 1.82, 95% CI 1.68-1.98; aOR 1.76, 95% CI 1.06-2.90) compared with NHWs. (4) Caribbean-born Blacks living with HIV infection are less likely than other racial/ethnic groups to be retained in care and/or achieve viral suppression. Further research is urgently needed to determine social, cultural, and biological factors that contribute to this disparity.

Keywords: Caribbean; disparity; human immunodeficiency virus; immigrant; retention; suppression.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-HIV Agents / therapeutic use*
  • Black People / statistics & numerical data
  • Black or African American / statistics & numerical data
  • Caribbean Region
  • Emigrants and Immigrants / psychology*
  • Emigrants and Immigrants / statistics & numerical data
  • Ethnicity / statistics & numerical data*
  • Female
  • Florida / ethnology
  • HIV Infections / drug therapy*
  • HIV Infections / ethnology*
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Viral Load / drug effects*
  • White People / statistics & numerical data
  • Young Adult

Substances

  • Anti-HIV Agents