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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.

Author information

1
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. mln7@cdc.gov.
2
Division of HIV/AIDS Prevention (DHAP) at NCHHSTP, CDC, Atlanta, GA 30329, USA. mln7@cdc.gov.
3
Division of HIV/AIDS Prevention (DHAP) at NCHHSTP, CDC, Atlanta, GA 30329, USA. ats5@cdc.gov.
4
ICF International, DHAP, NCHHSTP, CDC, Atlanta, GA 30329, USA. hongzhu1116@gmail.com.
5
Division of HIV/AIDS Prevention (DHAP) at NCHHSTP, CDC, Atlanta, GA 30329, USA. uwf5@cdc.gov.
6
Division of Global HIV and TB, National Center for Global Health, CDC, Atlanta, GA 30329, USA. wed4@cdc.gov.
7
Office of the Director, at NCHHSTP, CDC, Atlanta, GA 30329, USA. hdd0@cdc.gov.

Abstract

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.

KEYWORDS:

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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