Abstract
(1) The study aim was to assess disparities in non-retention in HIV care and non-viral suppression among non-Hispanic Black Caribbean immigrants living with HIV in Florida. (2) We analyzed cases involving individuals, aged ≥13, who met CDC HIV case definition during 2000–2014. Chi square test was used to evaluate differences in non-retention and non-viral suppression by country of origin/race/ethnicity. Multilevel logistic regressions with three referent groups [US-born Blacks, Hispanics, and non-Hispanic Whites (NHWs)] were used to estimate adjusted odds ratios (aOR). (3) Caribbean-born Blacks were less likely to be retained in care or be virally suppressed than US-born Blacks, Hispanics, and NHWs. Bahamians, Haitians, and Trinidadians and Tobagonians had increased odds of non-retention (aOR 3.13, 95% confidence interval [CI] 2.40 –4.10; aOR 1.52, 95% CI 1.40–1.66; aOR 2.30, 95% CI 1.38–3.83), and non-viral suppression (aOR 3.23, 95% CI 2.48–4.21; aOR 1.82, 95% CI 1.68–1.98; aOR 1.76, 95% CI 1.06–2.90) compared with NHWs. (4) Caribbean-born Blacks living with HIV infection are less likely than other racial/ethnic groups to be retained in care and/or achieve viral suppression. Further research is urgently needed to determine social, cultural, and biological factors that contribute to this disparity.
Highlights
The rate of HIV diagnoses in Florida is almost three times the national average [1]
Haitians and Bahamians had a more even gender distribution among Caribbean countries, while Trinidadians and Tobagonians, Jamaicans, and US-born Blacks had a higher percentage of males living with HIV; Hispanics and non-Hispanic Whites (NHWs) had the highest percentages of male cases
US-born Blacks, Bahamians, and Hispanics had the most individuals diagnosed in the 13–24 year-old age group
Summary
The rate of HIV diagnoses in Florida is almost three times the national average [1]. Reduction in HIV incidence is possible if a larger proportion of persons living with HIV are consistently engaged and retained in care [2]. Retention in care is a critical factor for persons living with HIV to achieve viral suppression. Persons living with HIV who are in routine care and achieve undetectable viral loads minimize the chances of transmitting the virus to HIV-uninfected individuals [3]. Just over one percent of the US population is composed of Caribbean immigrants [4]. Florida is home to approximately 40.0% of the total Caribbean-born population in the United States [5].
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