Unique Aspects of the Care of HIV-Positive Latino Patients Living in the United States

Garland, Joseph; Andrade, Adriana; Page, Kathleen R.

doi:10.1007/s11904-010-0049-1

Cited by 11 publications

(7 citation statements)

References 45 publications

(39 reference statements)

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“…Unfortunately, HIV-related interventions have faced many unique challenges because Hispanics as a group in the US are considerably diverse in their cultural backgrounds. Their comparatively high rates of poverty, low education, and lack of insurance, along with language barriers, immigration issues, and diverse cultural beliefs about sexuality, have further impeded HIV prevention and treatment efforts 42,43. Consequently, Hispanics have a comparatively low rate of HIV testing and a high rate of late HIV diagnosis 43.…”

Section: Discussionmentioning

confidence: 99%

“…Their comparatively high rates of poverty, low education, and lack of insurance, along with language barriers, immigration issues, and diverse cultural beliefs about sexuality, have further impeded HIV prevention and treatment efforts 42,43. Consequently, Hispanics have a comparatively low rate of HIV testing and a high rate of late HIV diagnosis 43. These findings clearly highlight the need for research to monitor and discern patterns of HIV risk behaviors continuously and to develop culturally and linguistically appropriate HIV risk reduction interventions to meet the diverse needs of Hispanics.…”

Section: Discussionmentioning

confidence: 99%

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Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

Wu¹

2010

SAR

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PurposeDetoxification often serves as an initial contact for treatment and represents an opportunity for engaging patients in aftercare to prevent relapse. However, there is limited information concerning clinical profiles of individuals seeking detoxification, and the opportunity to engage patients in detoxification for aftercare often is missed. This study examined clinical profiles of a geographically diverse sample of opioid-dependent adults in detoxification to discern the treatment needs of a growing number of women and whites with opioid addiction and to inform interventions aimed at improving use of aftercare or rehabilitation.MethodsThe sample included 343 opioid-dependent patients enrolled in two national multisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001–002). Patients were recruited from 12 addiction treatment programs across the nation. Gender and racial/ethnic differences in addiction severity, human immunodeficiency virus (HIV) risk, and quality of life were examined.ResultsWomen and whites were more likely than men and African Americans to have greater psychiatric and family/social relationship problems and report poorer health-related quality of life and functioning. Whites and Hispanics exhibited higher levels of total HIV risk scores and risky injection drug use scores than African Americans, and Hispanics showed a higher level of unprotected sexual behaviors than whites. African Americans were more likely than whites to use heroin and cocaine and to have more severe alcohol and employment problems.ConclusionsWomen and whites show more psychopathology than men and African Americans. These results highlight the need to monitor an increased trend of opioid addiction among women and whites and to develop effective combined psychosocial and pharmacologic treatments to meet the diverse needs of the expanding opioid-abusing population. Elevated levels of HIV risk behaviors among Hispanics and whites also warrant more research to delineate mechanisms and to reduce their risky behaviors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

Wu¹

2010

SAR

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“…Two studies elsewhere found that: (1) 28% of facility and population-recruited HIV-positive persons from 18 states did not enter HIV treatment within 3 months 18 and (2) 21% of hospitalized HIV-positive crack cocaine smokers in Miami and Atlanta had never been to a doctor or clinic for HIV care, even though two thirds had received their diagnosis more than 5 years ago. 19 Such disparities and delays in care perpetuate avoidable morbidity, mortality, and costly medical care [20][21][22][23] as well as HIV transmission. 6 The Centers for Disease Control and Prevention (CDC) is currently implementing a population-based system to estimate the number of persons diagnosed with HIV who have not initiated care, identify their reasons for delaying care and provide regional population comparisons.…”

Section: Introductionmentioning

confidence: 99%

A Community-Based Study of Barriers to HIV Care Initiation

Pollini

Blanco

Crump

et al. 2011

AIDS Patient Care and STDs

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Timely treatment of HIV infection is a public health priority, yet many HIV-positive persons delay treatment initiation. We conducted a community-based study comparing HIV-positive persons who received an HIV diagnosis at least 3 months ago but had not initiated care (n = 100) with a reference population of HIV-positive persons currently in care (n = 115) to identify potential barriers to treatment initiation. Study participants were mostly male (78.0%), and persons of color (54.9% Latino, 26.3% black), with median age 37.8 years. Median time since HIV diagnosis was 3.7 years. Univariate analysis revealed that those never in care differed substantially from those currently in care with regard to sociodemographics; HIV testing and counseling experiences; perceived barriers to care; and knowledge, attitudes, and beliefs regarding HIV. , and not wanting to think about being HIV positive (AOR = 3.57; 95% CI: 1.22, 10.46). Our findings suggest that isolation and stigma remain significant barriers to initiating HIV care in populations consisting primarily of persons of color, and that direct linkages to HIV care at the time of diagnosis are critical to promoting timely care initiation in these populations.

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“…There can also be particular challenges for Latinos due to linguistic barriers and differences in patient-provider communication. For example, prior studies have identified less patient-centred and psychosocial language use by HIV clinicians treating Hispanics versus non-Hispanics [ 6 – 8 ].…”

Section: Discussionmentioning

confidence: 99%

Health outcomes among HIV‐positive Latinos initiating antiretroviral therapy in North America versus Central and South America

César

Koethe

Giganti

et al. 2016

Journal of the International AIDS Society

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IntroductionLatinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America.MethodsHIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts.ResultsThe study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57).ConclusionsHIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation.

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Unique Aspects of the Care of HIV-Positive Latino Patients Living in the United States

Cited by 11 publications

References 45 publications

Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

A Community-Based Study of Barriers to HIV Care Initiation

Health outcomes among HIV‐positive Latinos initiating antiretroviral therapy in North America versus Central and South America

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