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Int J Environ Res Public Health. 2018 Oct 30;15(11). pii: E2404. doi: 10.3390/ijerph15112404.

HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016.

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Oak Ridge Institute for Science and Education, Office of Health Equity in the Office of the Director at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA.
Division of HIV/AIDS Prevention (DHAP) at NCHHSTP, CDC, Atlanta, GA 30329, USA.
Division of HIV/AIDS Prevention (DHAP) at NCHHSTP, CDC, Atlanta, GA 30329, USA.
ICF International, DHAP, NCHHSTP, CDC, Atlanta, GA 30329, USA.
Division of HIV/AIDS Prevention (DHAP) at NCHHSTP, CDC, Atlanta, GA 30329, USA.
Division of Global HIV and TB, National Center for Global Health, CDC, Atlanta, GA 30329, USA.
Office of the Director, at NCHHSTP, CDC, Atlanta, GA 30329, USA.


HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.


African Americans; acquired immunodeficiency syndrome; emigrants and immigrants; health disparity; human immunodeficiency virus; late diagnosis; linkage to HIV medical care; retention in medical care; sustained virologic response; viral suppression

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