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Am J Public Health. 2018 Nov;108(S4):S292-S298. doi: 10.2105/AJPH.2018.304506.

Trends and Racial Disparities of Late-Stage HIV Diagnosis: Hawaii, 2010-2016.

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Fenfang Li and Glenn M. Wasserman are with the Communicable Disease and Public Health Nursing Division, Hawaii State Department of Health, Honolulu. Brandi K. Juan, Michelle Wozniak, Stuart K. Watson, Peter M. Whiticar, Timothy McCormick, and Yuanshan "Sandy" Qiu are with the Harm Reduction Services Branch, Communicable Disease and Public Health Nursing Division, Hawaii State Department of Health. Alan R. Katz is with the Office of Public Health Studies, University of Hawaii, Honolulu.



To examine racial/ethnic disparities in Hawaii in stage 3 classification at HIV diagnosis and trends in such disparities from 2010 through 2016.


We analyzed data including patients' demographic information, behavioral risk factors, residential county at HIV diagnosis, and type of facility where HIV was diagnosed. Multivariable logistic regression modeling was used to examine racial/ethnic disparities in late-stage diagnoses after adjustment for known or possible confounders.


About 30% of HIV diagnoses were classified as late-stage (stage 3) diagnoses, and there were significant racial/ethnic disparities in stage 3 classification at diagnosis. Relative to Whites, the odds of being diagnosed at stage 3 were 3.7 times higher among Native Hawaiians and other Pacific Islanders (NHPIs; odds ratio [OR] = 3.69; 95% confidence interval [CI] = 1.89, 7.22) and more than twice as high among Asians (OR = 2.46; 95% CI = 1.16, 5.20). Older age and being diagnosed in an inpatient setting were associated with stage 3 classification.


Targeted preventive services need to be strengthened for Asians and NHPIs in Hawaii.

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