Differences in Characteristics and Clinical Outcomes Among Hispanic/Latino Men and Women Receiving HIV Medical Care — United States, 2013–2014

Ruth E. Luna-Gierke, MPH; R. Luke Shouse, MD; Qingwei Luo, MS; Emma Frazier, PhD; Guangnan Chen, MD; Linda Beer, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2018;67(40):1109-1114. 

In This Article

Abstract and Introduction

Introduction

The prevalence of diagnosed human immunodeficiency virus (HIV) infection among Hispanics/Latinos in the United States is approximately twice that of non-Hispanic whites.[1] Barriers to, and experiences with, medical care have been found to vary by sex.[2] Describing characteristics of Hispanics/Latinos in care by sex can help identify disparities and inform delivery of tailored services to this underserved population. Data from the 2013 and 2014 cycles of the Medical Monitoring Project (MMP) were analyzed to describe demographic, behavioral, and clinical characteristics among Hispanics/Latinos by sex. MMP is an annual cross-sectional, nationally representative surveillance system that, during 2013–2014, collected information about behaviors, medical care, and clinical outcomes among adults receiving outpatient HIV care. Hispanic/Latina women were significantly more likely than were men to live in poverty (78% versus 54%), report not speaking English well (38% versus 21%), and receive interpreter (27% versus 16%), transportation (35% versus 21%), and meal (44% versus 26%) services. There were no significant differences between Hispanic/Latino women and men in prescription of antiretroviral therapy (ART) (95% versus 96%) or sustained viral suppression (68% versus 73%). Although women faced greater socioeconomic and language-related challenges, the clinical outcomes among Hispanic/Latina women were similar to those among men, perhaps reflecting their higher use of ancillary services. Levels of viral suppression for Hispanics/Latinos are lower than those found among non-Hispanic whites[3] and lower than the national prevention goal of at least 80% of persons with diagnosed HIV infection. Providers should be cognizant of the challenges faced by Hispanics/Latinos with HIV infection in care and provide referrals to needed ancillary services.

MMP data were collected annually during 2013–2014 using three consecutive sampling stages (states and territories, outpatient HIV facilities, and patients), and response rates for the two cycle-years of data that were included in the analysis were 100% (states and territories), 85%–86% (outpatient HIV facilities) and 55%–56% (patients). Data were collected using face-to-face or telephone interviews and medical record abstraction from June 2013 through May 2015.

The analysis included 1,774 men and 577 women who self-identified as Hispanic or Latino, regardless of race. Data were self-reported from the interview and abstracted from the respondent's medical record. Data were weighted based on known probabilities of selection and adjusted for facility and patient non-response. Rao-Scott chi-square tests were used to assess differences by sex; p-values <0.05 were considered statistically significant. Selected sociodemographic and behavioral variables, use of ancillary services, and clinical outcomes are presented by sex. All analyses accounted for the complex sample design and weights.

Women were significantly more likely than were men to live in poverty (78% versus 54%), live in a household with ≥1 dependents aged <18 years (66% versus 37%), have public insurance coverage (72% versus 54%) and, among those living outside of Puerto Rico, report not speaking English well (38% versus 21%) (Table 1). Compared with men, women were less likely to have more than a high school education (28% versus 47%), be employed (29% versus 48%), have any private insurance (14% versus 22%), and have been born outside the United States (36% versus 45%). Women most often reported their country or region of origin in the Caribbean (including Puerto Rico) (38%), followed by the mainland United States (33%). Men most often reported the mainland United States as their country or region of origin (36%), followed by Mexico and Central America (32%) (Table 1). Women were also less likely than were men to report using stimulants (3% versus 10%), non-injection drugs (8% versus 23%), injection drugs (0.4% versus 3%), or any opioids (0.8% versus 3%) (Table 2). Women were more likely than men to receive interpreter (27% versus 16%), transportation (35% versus 21%), and meal services (44% versus 26%). Women did not report a greater unmet need for these services than did men. Among women and men, prescription of antiretroviral therapy (95% versus 96%) and prevalence of sustained viral suppression (68% versus 73%) did not significantly differ.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....