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. 2023 Feb 24:1–18. Online ahead of print. doi: 10.1007/s10900-023-01191-y

Table 2.

Association between Linkage to HIV Medical Care and Social Vulnerability Index among Black/African American, Hispanic/Latino, and White Adults in the Southern United States, by Selected Characteristics, and Region of Residence—Census Tract-Level, 2018

Black/African American
Total diagnoses Total linkage Quarter 1 (lowest vulnerability) Quarter 2 Quarter 3 Quarter 4 (highest vulnerability) Quarter 4 vs. Quarter 1
Diagnoses Linkage Diagnoses Linkage Diagnoses Linkage Diagnoses Linkage
No %a No %b No No %c No No %c No No %c No No %c PR 95% CId
Male
 Age at diagnosis (yrs)
 18–24 1,787 29.0 1,347 75.4 151 113 74.8 266 210 78.9 493 372 75.5 832 621 74.6 1.0 0.90 1.10
 25–34 2,465 40.0 1,855 75.3 218 172 78.9 389 289 74.3 670 501 74.8 1,157 872 75.4 1.0 0.89 1.03
 35–44 887 14.4 697 78.6 82 64 78.0 127 104 81.9 232 178 76.7 429 342 79.7 1.0 0.90 1.16
 45–54 558 9.1 400 71.7 41 33 80.5 76 51 67.1 119 82 68.9 306 220 71.9 0.9 0.76 1.05
 55 +  460 7.5 362 78.7 49 41 83.7 51 38 74.5 106 87 82.1 249 193 77.5 0.9 0.80 1.07
 Transmission categorye
 Male-to-male sexual contact 4,888 79.4 3,720 76.1 451 355 78.5 745 573 76.9 1,323 1,009 76.2 2,272 1,717 75.6 1.0 0.91 1.02
 Injection drug use 150 2.4 107 71.4 8 6 76.3 19 12 64.6 36 25 69.2 84 62 73.7 1.0 0.64 1.46
 Male-to-male sexual contact and injection drug use 100 1.6 70 70.1 8 6 81.0 16 9 58.6 25 15 61.8 49 38 77.1 1.0 0.66 1.38
 Heterosexual contact 1,016 16.5 762 75.0 74 56 75.9 129 97 75.7 235 171 72.5 567 431 76.0 1.0 0.87 1.15
 Other 3 0.1 2 44.1 0 0 100.0 0 0 75.0 1 1 58.3 2 0 18.8 – – –
 Region
 Deep South 5,104 82.9 3,842 75.3 382 289 75.7 697 535 76.8 1,303 969 74.4 2,621 1,982 75.6 1.0 0.94 1.06
 Other South 1,053 17.1 819 77.8 159 134 84.3 212 157 74.1 317 251 79.2 352 266 75.6 0.9 0.82 0.98
 Subtotal 6,157 100.0 4,661 75.7 541 423 78.2 909 692 76.1 1620 1,220 75.3 2973 2,248 75.6 1.0 0.92 1.02
Female
 Age at diagnosis (yrs)
 18–24 298 13.5 228 76.5 19 15 78.9 40 34 85.0 62 51 82.3 173 125 72.3 0.9 0.71 1.18
 25–34 594 26.9 461 77.6 46 35 76.1 67 61 91.0 134 104 77.6 334 252 75.4 1.0 0.83 1.18
 35–44 525 23.8 422 80.4 34 25 73.5 61 54 88.5 148 120 81.1 274 216 78.8 1.1 0.87 1.32
 45–54 421 19.1 334 79.3 26 21 80.8 60 51 85.0 91 71 78.0 234 185 79.1 1.0 0.80 1.19
 55 +  367 16.6 301 82.0 21 19 90.5 46 38 82.6 85 70 82.4 205 165 80.5 0.9 0.76 1.04
 Transmission categorye
 Injection drug use 127 5.8 95 74.9 7 6 84.5 16 13 80.5 29 22 77.2 73 53 72.1 0.9 0.60 1.21
 Heterosexual contact 2072 93.9 1,645 79.4 138 108 78.3 258 225 87.2 490 392 80.1 1,144 887 77.6 1.0 0.90 1.09
 Other 7 0.3 6 93.9 1 1 92.3 0 0 100.0 2 2 95.0 3 3 96.7 – – –
 Region
 Deep South 1,781 80.8 1,393 78.2 83 65 78.3 195 166 85.1 387 308 79.6 1,077 826 76.7 1.0 0.87 1.10
 Other South 424 19.2 353 83.3 63 50 79.4 79 72 91.1 133 108 81.2 143 117 81.8 1.0 0.89 1.20
 Subtotal 2,205 100.0 1,746 79.2 146 115 78.8 274 238 86.9 520 416 80.0 1220 943 77.3 1.0 0.90 1.07
 Totalf 8,362 100.0 6407 76.6 687 538 78.3 1,183 930 78.6 2140 1,636 76.4 4193 3,191 76.1 1.0 0.93 1.01
Hispanic/Latino
Total diagnoses Total linkage Quarter 1 (lowest vulnerability) Quarter 2 Quarter 3 Quarter 4 (highest vulnerability) Quarter 4 vs. Quarter 1
Diagnoses Linkage Diagnoses Linkage Diagnoses Linkage Diagnoses Linkage
No %a No %a No No %c No No %c No No %c No No %c PR 95% CId
Male
 Age at diagnosis (yrs)
 18–24 642 19.4 492 76.6 57 42 73.7 104 79 76.0 172 137 79.7 301 228 75.7 1.0 0.87 1.22
 25–34 1,284 38.9 1,045 81.4 154 125 81.2 220 181 82.3 344 281 81.7 553 449 81.2 1.0 0.92 1.09
 35–44 694 21.0 590 85.0 67 60 89.6 135 118 87.4 159 134 84.3 322 269 83.5 0.9 0.85 1.03
 45–54 472 14.3 415 87.9 50 45 90.0 71 63 88.7 116 103 88.8 230 199 86.5 1.0 0.87 1.07
 55 +  212 6.4 173 81.6 18 18 100.0 37 34 91.9 55 40 72.7 99 78 78.8 – – –
 Transmission categorye
 Male-to-male sexual contact 2858 86.5 2358 82.5 311 262 84.4 498 418 83.9 727 595 81.7 1286 1055 82.0 1.0 0.92 1.03
 Injection drug use 78 2.4 63 80.1 6 6 91.9 14 13 86.8 17 13 77.2 39 30 76.7 0.8 0.62 1.11
 Male-to-male sexual contact and injection drug use 85 2.6 60 70.2 10 7 74.7 12 11 87.7 30 23 76.4 34 19 57.0 0.8 0.48 1.22
 Heterosexual contact 282 8.5 234 83.0 20 15 76.4 43 34 79.9 72 64 89.8 146 118 81.1 1.1 0.82 1.38
 Other 1 0.0 1 100.0 0 0 - 0 0 - 0 0 100.0 1 1 100.0 – – –
 Region
 Deep South 3,083 93.3 2531 82.1 309 260 84.1 512 429 83.8 782 638 81.6 1446 1177 81.4 1.0 0.92 1.02
 Other South 221 6.7 184 83.3 37 30 81.1 55 46 83.6 64 57 89.1 59 46 78.0 1.0 0.78 1.18
 Subtotal 3,304 100.0 2,715 82.2 346 290 83.8 567 475 83.8 846 695 82.2 1505 1223 81.3 1.0 0.92 1.02
Female
 Age at diagnosis (yrs)
 18–24 61 12.2 52 85.2 5 4 80.0 10 9 90.0 14 10 71.4 31 28 90.3 1.1 0.72 1.78
 25–34 138 27.5 115 83.3 10 8 80.0 18 14 77.8 30 25 83.3 77 65 84.4 1.1 0.76 1.46
 35–44 117 23.4 97 82.9 9 8 88.9 11 9 81.8 36 31 86.1 61 49 80.3 0.9 0.70 1.17
 45–54 115 23.0 93 80.9 6 4 66.7 14 13 92.9 28 25 89.3 65 50 76.9 1.2 0.65 2.06
 55 +  70 14.0 55 78.6 5 5 100.0 9 5 55.6 22 20 90.9 34 25 73.5 – – –
 Transmission categorye
 Injection drug use 43 8.5 33 76.3 2 2 85.0 4 3 69.2 10 8 76.7 26 20 76.2 0.9 0.48 1.67
 Heterosexual contact 457 91.2 378 82.7 33 27 82.7 58 47 81.4 120 103 86.1 241 196 81.4 1.0 0.83 1.16
 Other 1 0.3 1 100.0 0 0 – 0 0 100.0 0 0 100.0 1 1 100.0 – – –
 Region
 Deep South 466 93.0 383 82.2 30 25 83.3 55 43 78.2 124 108 87.1 252 203 80.6 1.0 0.81 1.15
 Other South 35 7.0 29 82.9 5 4 80.0 7 7 100.0 6 3 50.0 16 14 87.5 – – –
 Subtotal 501 100.0 412 82.2 35 29 82.9 62 50 80.6 130 111 85.4 268 217 81.0 1.0 0.83 1.15
 Totalf 3,805 100.0 3,127 82.2 381 319 83.7 629 525 83.5 976 806 82.6 1,773 1440 81.2 1.0 0.92 1.02
White
Total diagnoses Total linkage Quarter 1 (lowest vulnerability) Quarter 2 Quarter 3 Quarter 4 (highest vulnerability) Quarter 4 vs. Quarter 1
Diagnoses Linkage Diagnoses Linkage Diagnoses Linkage Diagnoses Linkage
No %a No %b No No %c No No %c No No %c No No %c PR 95% CId
Male
 Age at diagnosis (yrs)
 18–24 427 14.7 337 78.9 82 68 82.9 108 78 72.2 140 121 86.4 87 63 72.4 0.9 0.74 1.03
 25–34 995 34.2 840 84.4 219 191 87.2 247 206 83.4 251 212 84.5 260 215 82.7 0.9 0.88 1.02
 35–44 566 19.5 475 83.9 120 101 84.2 145 125 86.2 165 137 83.0 127 104 81.9 1.0 0.87 1.09
 45–54 524 18.0 445 84.9 134 113 84.3 144 127 88.2 126 112 88.9 109 85 78.0 0.9 0.82 1.05
 55 +  398 13.7 337 84.7 100 88 88.0 96 84 87.5 106 87 82.1 91 74 81.3 0.9 0.82 1.04
 Transmission categorye
 Male-to-male sexual contact 2,353 80.9 1,987 84.4 557 475 85.3 609 512 84.1 629 540 85.8 514 423 82.2 1.0 0.91 1.02
 Injection drug use 139 4.8 108 77.8 14 12 84.2 20 20 97.5 39 31 79.7 62 45 72.0 0.9 0.65 1.13
 Male-to-male sexual contact and injection drug use 205 7.0 165 80.4 44 37 84.4 49 37 74.8 57 49 85.7 50 38 74.8 0.9 0.72 1.09
 Heterosexual contact 210 7.2 172 81.8 41 37 91.6 61 51 83.4 61 48 78.4 47 35 75.6 0.8 0.68 0.99
 Other 3 0.1 2 84.6 0 0 100.0 1 0 66.7 1 1 90.0 1 1 87.5 0.9 0.00 –
 Region
 Deep South 2,500 85.9 2,099 84.0 531 464 87.4 645 535 82.9 680 576 84.7 600 488 81.3 0.9 0.89 0.98
 Other South 410 14.1 335 81.7 124 97 78.2 95 85 89.5 108 93 86.1 74 53 71.6 0.9 0.77 1.09
 Subtotal 2,910 100.0 2,434 83.6 655 561 85.6 740 620 83.8 788 669 84.9 674 541 80.3 0.9 0.89 0.98
Female
 Age at diagnosis (yrs)
 18–24 66 11.8 48 72.7 10 9 90.0 17 12 70.6 18 13 72.2 20 13 65.0 0.7 0.49 1.06
 25–34 170 30.5 129 75.9 19 15 78.9 44 33 75.0 41 36 87.8 59 41 69.5 0.9 0.66 1.17
 35–44 134 24.1 99 73.9 19 14 73.7 16 15 93.8 41 31 75.6 56 37 66.1 0.9 0.65 1.24
 45–54 119 21.4 86 72.3 7 6 85.7 29 19 65.5 38 28 73.7 40 29 72.5 0.8 0.59 1.21
 55 +  68 12.2 55 80.9 14 12 85.7 16 12 75.0 17 15 88.2 20 15 75.0 0.9 0.63 1.22
 Transmission categorye
 Injection drug use 152 27.3 102 67.3 13 9 72.9 34 26 76.4 46 34 73.7 54 31 57.6 0.8 0.53 1.18
 Heterosexual contact 404 72.5 314 77.7 56 47 83.1 88 65 73.8 109 89 81.8 141 104 73.7 0.9 0.76 1.03
 Other 1 0.2 1 83.3 0 0 – 1 1 83.3 1 0 80.0 0 0 100.0 – – –
 Region
 Deep South 480 86.2 364 75.8 58 48 82.8 99 76 76.8 137 109 79.6 175 124 70.9 0.9 0.74 1.00
 Other South 77 13.8 53 68.8 11 8 72.7 23 15 65.2 18 14 77.8 20 11 55.0 0.8 0.44 1.29
 Subtotal 557 100.0 417 74.9 69 56 81.2 122 91 74.6 155 123 79.4 195 135 69.2 0.9 0.74 0.99
 Totalf 3,467 100.0 2,851 82.2 724 617 85.2 862 711 82.5 943 792 84.0 869 676 77.8 0.9 0.87 0.96

Hispanic/Latino persons can be of any race

CI = confidence interval; PR = proportion ratio

SVI scores were grouped into quartiles according to their distribution among US census tracts. Proportions were considered significantly different if the 95% CIs of the PRs excluded one

aColumn percent

bDenominator of percent is total number of HIV diagnoses

cDenominator of percent is number of HIV diagnoses in the quarter

dTwo proportions are statistically different if the 95% CI does not include 1.0

eTransmission category is classified based on a hierarchy of the risk factors most likely responsible for HIV transmission. Statistical adjustments were performed for missing HIV transmission categories

f Total included 159 Black/African American, 46 Hispanic/Latino, and 69 White adults without SVI rankings