Geographic disparities in late HIV diagnoses in Tennessee: Opportunities for interventions in the rural Southeast

Details

• Alternative Title:
  J Rural Health
• Personal Author:
  Gibas, Kevin M. ; Rebeiro, Peter F. ; Brantley, Meredith ; Mathieson, Samantha ; Maurer, Laurie ; Pettit, April C.
• Description:
  Purpose:
  
  Incident HIV remains an important public health issue in the U.S. South, the region leading the nation in HIV incidence, rural HIV cases, and HIV-related deaths. Late diagnoses drive incident HIV and understanding factors driving late diagnoses is critical for developing locally relevant HIV testing and prevention interventions, decreasing HIV transmission, and ending the HIV epidemic.
  
  Methods:
  
  Retrospective cohort study utilizing Tennessee Department of Health (TDH) surveillance data and U.S. Census Bureau data. Adults ≥18 years old with a new HIV diagnosis between January 1, 2015 and December 31, 2019 identified in the TDH eHARS were included. Individuals were followed from initial HIV diagnosis until death, 90 days of follow-up for outcome assessment, or administrative censoring 90 days after study enrollment closed.
  
  Findings:
  
  We included 3,652 newly HIV-diagnosed individuals; median age was 31 years (IQR: 25, 42), 2909 (79.7%) were male, 2057 (56.3%) were Black, 246 (6.7%) were Hispanic, 408 (11.2%) were residing in majority-rural areas at diagnosis, and 642 (17.6%) individuals received a late HIV diagnosis. Residents of majority-rural counties (aRR=1.39, 95% CI: 1.16–1.67) and Hispanic individuals (aRR=1.87, 95% CI: 1.50–2.33) had an increased likelihood of receiving a late diagnosis after controlling for race/ethnicity, age, and year of HIV diagnosis.
  
  Conclusions:
  
  Rural residence and Hispanic ethnicity were associated with an increased risk of receiving a late HIV diagnosis in Tennessee. Future HIV testing and prevention efforts should be adapted to the needs of these vulnerable populations.
  
  
• Subjects:
  Adolescent Adult Cohort Studies Delayed Diagnosis Female HIV Infections Humans Male Middle Aged Retrospective Studies Rural Population Tennessee

  More +
• Keywords:
  AIDS HIV Late HIV Diagnoses Rural-urban Disparities Rural Health
• Source:
  J Rural Health. 40(4):699-708
• Pubmed ID:
  38361431
• Pubmed Central ID:
  PMC11324855
• Document Type:
  Journal Article
• Funding:
  L30 AI172003/AI/NIAID NIH HHSUnited States/ ; P30 AI110527/AI/NIAID NIH HHSUnited States/ ; R01 MH113438/MH/NIMH NIH HHSUnited States/ ; T32 HS026122/HS/AHRQ HHSUnited States/ ; P30 AI110527/AI/NIAID NIH HHSUnited States/ ; CDC-RFA-PS18-1802/Tennessee Integrated HIV Surveillance and Prevention Programs for Health Departments/ ; T32HS026122/Agency for Health Care Research and Quality funded PROgRESS/
• Volume:
  40
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b69ace2095269a131354c432742f38f9b56caf7921145b4fb2bc8f3b40468877fb34a2da129beeaca88b13953a104e5113d38d78b109dd10dfedc117e87c88a9
• Download URL:
  https://stacks.cdc.gov/view/cdc/168518/cdc_168518_DS1.pdf
• File Type:
  [PDF - 952.72 KB ]