Racial and ethnic disparities in HIV diagnoses among heterosexually active persons in the United States nationally and by state, 2018

Autor: Eli S. Rosenberg, Rachel Hart-Malloy, Erika G. Martin, Andrés A. Berruti, Kevin P. Delaney, Bahareh Ansari, Monica Trigg, Dawn K. Smith, Thomas L. Gift
Rok vydání: 2021
Předmět:
RNA viruses
Male
Epidemiology
Human immunodeficiency virus (HIV)
Ethnic group
HIV Infections
Pathology and Laboratory Medicine
Logistic regression
medicine.disease_cause
Race (biology)
Immunodeficiency Viruses
Ethnicities
Medical diagnosis
Hispanic People
Multidisciplinary
HIV diagnosis and management
Hispanic or Latino
Middle Aged
HIV epidemiology
Medical Microbiology
Viral Pathogens
Viruses
Medicine
Marital status
Female
Pathogens
Research Article
Adult
Adolescent
Science
HIV prevention
Health outcomes
Microbiology
White People
Ethnic Epidemiology
Young Adult
Retroviruses
medicine
Humans
Heterosexuals
Heterosexuality
Microbial Pathogens
Medicine and health sciences
Preventive medicine
National health
Lentivirus
Organisms
Biology and Life Sciences
HIV
Health Status Disparities
Health Surveys
Diagnostic medicine
United States
Black or African American
Public and occupational health
Logistic Models
People and Places
Population Groupings
Sexuality Groupings
Demography
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 9, p e0257583 (2021)
ISSN: 1932-6203
Popis: Background Despite declining HIV infection rates, persistent racial and ethnic disparities remain. Appropriate calculations of diagnosis rates by HIV transmission category, race and ethnicity, and geography are needed to monitor progress towards reducing systematic disparities in health outcomes. We estimated the number of heterosexually active adults (HAAs) by sex and state to calculate appropriate HIV diagnosis rates and disparity measures within subnational regions. Methods The analysis included all HIV diagnoses attributed to heterosexual transmission in 2018 in the United States, in 50 states and the District of Columbia. Logistic regression models estimated the probability of past-year heterosexual activity among adults in three national health surveys, by sex, age group, race and ethnicity, education category, and marital status. Model-based probabilities were applied to estimated counts of HAAs by state, which were synthesized through meta-analysis. HIV diagnoses were overlaid to calculate racial- and ethnic-specific rates, rate differences (RDs), and rate ratios (RRs) among HAAs by sex and state. Results Nationally, HAA women have a two-fold higher HIV diagnosis rate than HAA men (rate per 100,000 HAAs, women: 6.57; men: 3.09). Compared to White non-Hispanic HAAs, Black HAAs have a 20-fold higher HIV diagnosis rate (RR, men: 21.28, women: 19.55; RD, men: 15.40, women: 31.78) and Hispanic HAAs have a 4-fold higher HIV diagnosis rate (RR, men: 4.68, RD, women: 4.15; RD, men: 2.79, RD, women: 5.39). Disparities were ubiquitous across regions, with >75% of states in each region having Black-to-White RR ≥10. Conclusion The racial and ethnic disparities across regions suggests a system-wide failure particularly with respect to preventing HIV among Black and Hispanic women. Pervasive disparities emphasize the role for coordinated federal responses such as the current Ending the HIV Epidemic (EHE) initiative.
Databáze: OpenAIRE
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