Black-White Latino Racial Disparities in HIV Survival, Florida, 2000-2011

This research aimed to estimate Black/White racial disparities in all-cause mortality risk among HIV-positive Latinos. Florida surveillance data for Latinos diagnosed with HIV (2000-2008) were merged with 2007-2011 American Community Survey data. Crude and adjusted hazard ratios (aHR) were calculated using multi-level Cox regression. Of 10,903 HIV-positive Latinos, 8.2% were Black and 91.9% White. Black Latinos were at increased mortality risk compared with White Latinos after controlling for individual and neighborhood factors (aHR 1.40, 95% confidence interval (CI) 1.21-1.62). In stratified analyses, risk factors for Black Latinos included: age ≥60 years compared with ages 13-19 (aHR 4.63, 95% CI 1.32-16.13); US birth compared with foreign birth (aHR 1.56, 95% CI 1.16-2.11); diagnosis of AIDS within three months of HIV diagnosis (aHR 3.53, 95% CI 2.64-4.74); residence in the 3rd (aHR 1.82, 95% CI 1.13-2.94) and 4th highest quartiles (aHR 1.79, 95% CI 1.12-2.86) of neighborhood poverty compared with the lowest quartile; and residence in neighborhood with 25%-49% (aHR 1.59, 95% CI 1.07-2.42) and ≥50% Latinos compared with <25% Latinos (aHR 1.58, 95% CI 1.03-2.42). Significant racial disparities in HIV survival exist among Latinos. Differential access to-and quality of-care and perceived/experienced racial discrimination may be possible explanations.