Table 2.
Delayed enrollment in HIV care
| First Author, Pub. Year (Ref. No.) |
Source of Data, Location, Year |
Study population | N, %male, %Hispanic |
Age (median, years) |
Outcome of Interest |
Result | |||
|---|---|---|---|---|---|---|---|---|---|
| Levy 2007 (19) |
2000-2002 Northern California Public AIDS Program clinical database and county surveillance, San Mateo County |
All patients entering in San Mateo County AIDS program between Jan 2000-Mar 2002 |
N=391 M:74% H:24% |
US-born 35 (IQR 29-41) Immigrants 31 (IQR 27- 38) |
Prevalence of Opportunistic Infections (01) at entry into AIDS program (comparing U.S. born vs. foreign- born ) |
01 at presentation (Percentage) |
AOR* | ||
| U.S. born (7% Hispanic) | 17.2% | Ref. | |||||||
| Immigrants (79% Hispanic) | 29.8% (p= 0.009) |
2.98 (1.21-7.38) | |||||||
| AOR for 01 at diagnosis among Hispanics * | |||||||||
| U.S. born | Ref. | ||||||||
| Immigrant | 6.33 (0.58-69.68) | ||||||||
| *adjusted for monolingual status, Hispanic ethnicity | |||||||||
| Kelley 2007 (18) |
2000-2002 Grady Infectious Disease Program in Atlanta, GA |
Foreisn-born Mispanics from Spanish-speaking Latin American countries enrolled in care at Grady Infectious Disease Program |
N=75 M:72% H:100% |
38.5 | Proportion with AIDS at entry into care |
Proportion with AIDS at presentation: | |||
| Males | 57.7% | ||||||||
| Females | 10.0% | ||||||||
| Median CD4 | AOR for AIDS at diagnosis | ||||||||
| Hispanic Females | 224.5 | Ref. | |||||||
| Hispanic Males | 55 p=0.004 |
8.6 (1.3-58.7) | |||||||
| Schwarcz 2007 (20) |
1997-2001, 39 sites in 10 US cities |
Patients with HIV diagnosed in past y12 months, enrolled consecutively from the 39 sites, ≥18yo, never been on ARV |
n=964 M:75% H:21% |
41.5% were between ages 25-34 |
Prevalence of HIV diagnosis within 6 months of infection |
Early HIV diagnosis | AOR* | ||
| White | 29.3% | Ref. | |||||||
| Black | 15.5% | 0.52 (0.3-0.8) | |||||||
| Hispanic | 15.5% | 0.50 (0.3-0.8) | |||||||
| * adjusted for gender, age, risk behavior, history of STI, clinic type, and city | |||||||||
| Carabin 2008 (10) |
2002-2004 Special Projects of National Significance (SPNS) Sites located along the U.S.-Mexico border |
HIV-positive patients receiving care at one of the SPNS sites in Harlingen and El Paso, Texas; Las Cruces, New Mexico; San Ysidro, California; and Tucson, Arizona |
N=707 M:82% H: 62% |
44% were between 30-39 |
AIDS or 01 at entry into care |
Median CD4 at presentation | |||
| Non-Hispanic | 376 (IQR 9-1188) | ||||||||
| Hispanics | 246 (IQR 4-1549) | p< 0.005 | |||||||
| Risk of 01 or AIDS at presentation of Hispanics compared to non-Hispanics by site | |||||||||
| Site | OR 01 at presentation | OR AIDS at presentation | |||||||
| A | 1.39 (0.57-3.29) | 1.85 (0.89-4.17) | |||||||
| B | 1.92 (1.03-3.80) | 2.03 (1.14-3.53) | |||||||
| C | 0.91 (0.49-1.83) | 1.19 (0.72-2.00) | |||||||
| D | 1.48 (0.58-3.75) | 0.93 (0.36-2.07) | |||||||
| E | 1.99 (1.04-4.18) | 1.92 (1.06-3.58) | |||||||
| Wohl 2009 (22) |
2000-2004 Los Angeles County |
≥18 years-old, Latino, diagnosed with AIDS and reported to Los Angeles County |
N=383 M:83 H:100% Foreign-born: 80% |
46% were between ages 30-39 |
Late tester defined as receiving AIDS diagnosis within 12 months of HIV diagnosis |
Odds ratio of Late HIV testing | |||
| Gender | Unadjusted OR | Adjusted OR* | |||||||
| Male | Ref. | Ref. | |||||||
| Female | 0.9(0.5-1.5) | -- | |||||||
| Place of birth | |||||||||
| US-born | Ref. | Ref. | |||||||
| Foreign-born | 2.4 (1.4-4.0) | 0.9 (0.4-2.0) | |||||||
| Language of Interview | |||||||||
| English | Ref. | Ref. | |||||||
| Spanish | 3.0 (1.9-4.8) | 2.9 (1.4-6.0) | |||||||
| *adjusted for age, place of birth, education level, language of interview, and history of injection drug use | |||||||||
| Althoff 2010 (9) |
1997-2007 North American Cohort Collaboration on Research and Design (NA- ACCORD) |
HIV-infected adults, > 18 yo, who first presented for clinical care between Jan 1997-Dec 2007 to 13 clinical cohorts in 17 U.S. states, Washington, D.C., and 3 Canadian provinces |
N=44,491 M:81% H:14% |
41 (IQR 34- 48) |
First measured CD4 count |
Observed mean CD4 + SD | Estimated change in CD4 (95% CI) | ||
| 1997 | 2007 | ||||||||
| White | 328±271 | 382±280 | 6 (5-7) | ||||||
| Black | 305±261 | 328±279 | 5 (3-7) | ||||||
| Latino | 293±246 | 383±301 | 9 (7-12) | ||||||
| *adjusted for age, sex, HIV transmission risk group, and cohort | |||||||||
| Giordano 2010(14) |
1999-2002, Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) FIRST trial, 18 clinical trial units in the U.S. |
>13 years old, antiretroviral naive, randomly allocated to three ARV strategies: PI strategy (PI+NRTI); NNRTI strategy (NNRTI+NRTI); or three-class strategy (PI+NNRTI+NRTI) |
N=1397 M:79% H:17% |
Median age of Hispanics 36.7 years |
Time from HAART initiation to AIDS- defining event or death |
Unadjusted HR | Adjusted HR* | ||
| White | Ref. | Ref. | |||||||
| Black | 1.61 (1.14-2.27) | 1.36 (0.95-1.94) | |||||||
| Hispanic | 1.82 (1.20-2.76) | 1.48 (0.97-2.25) | |||||||
| *adjusted for age, gender, prior AIDS, injection drug use, hepatitis C coinfection, baseline CD4 cell count, HIV RNA level, and FIRST randomized strategy group | |||||||||
AOR adjusted odds ratio, ARV antiretroviral, CDC Centers for disease control and prevention, H Hispanic, HR hazard ratio, IQR interquartile range, M male, MSM men who have sex with men, N/A not available, NNRTI non-nucleoside reverse transcriptase inhibitor, NRTI nucleoside reverse transcriptase inhibitor, OI opportunistic infection, OR odds ratio, PI protease inhibitor, Pub publication, Ref reference, STI sexually transmitted infection
Color scheme grey-Hispanics with worse outcome