Men Who have Sex with Men: Racial/Ethnic Disparities in Estimated HIV/AIDS Prevalence at the State and County Level, Florida

ABSTRACTBackgroundRacial and ethnic minority men who have sex with men (MSM) are disproportionately affected by HIV/AIDS in Los Angeles County (LAC), an important epicenter in the battle to end HIV.ObjectiveTo examine tradeoffs between effectiveness and equality of PrEP allocation strategies among different racial and ethnic groups of MSM in LAC.Design, Setting, and PopulationWe developed a microsimulation model of HIV among MSM in LAC using county epidemic surveillance and survey data to capture demographic trends and subgroup-specific partnership patterns, disease progression, patterns of PrEP use, and patterns for viral suppression.InterventionWe simulated interventions where an additional 3000, 6000, or 9000 PrEP prescriptions are provided annually in addition to current levels, following different allocation scenarios to each racial/ethnic group (Black, Hispanic, or White).MeasurementsWe estimated cumulative infections averted and measures of equality, after 15 years (2021-2035), relative to base case (no intervention).ResultsOf the policies evaluated, targeting PrEP preferentially to Black individuals would result in the largest reductions in incidence and disparities. This outcome was robust to different partnership preference assumptions, though the magnitude of impact differs.LimitationsWe limit analysis to MSM, who bear the majority of HIV/AIDS burden in LAC. We do not consider transmission via injection drug use or mother-to-child transmission, nor do we capture individual network transmission effects. We assume no improvements in the prevention-diagnosis-treatment cascade besides increased PrEP use.ConclusionsWe find there is little trade-off between effectiveness and equality of outcome when choosing groups to target for PrEP in LAC – by focusing on MSM with the highest HIV incidence (Black), we can reduce both overall infections and racial/ethnic disparities.

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HIV/AIDS and Racial/Ethnic Disparities

The SAGE Encyclopedia of LGBTQ Studies ◽

10.4135/9781483371283.n191 ◽

2016 ◽

Keyword(s):

Ethnic Disparities ◽

Racial Ethnic ◽

Hiv Aids

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County‐Level Factors Associated With Cardiovascular Mortality by Race/Ethnicity

Journal of the American Heart Association ◽

10.1161/jaha.120.018835 ◽

2021 ◽

Vol 10 (6) ◽

Author(s):

Bongeka Z. Zuma ◽

Justin T. Parizo ◽

Areli Valencia ◽

Gabriela Spencer‐Bonilla ◽

Manuel R. Blum ◽

...

Keyword(s):

Risk Factors ◽

Healthcare Access ◽

Ethnic Disparities ◽

County Level ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Race Ethnicity ◽

Racial Ethnic ◽

Hispanic White ◽

Cvd Mortality

Background Persistent racial/ethnic disparities in cardiovascular disease (CVD) mortality are partially explained by healthcare access and socioeconomic, demographic, and behavioral factors. Little is known about the association between race/ethnicity‐specific CVD mortality and county‐level factors. Methods and Results Using 2017 county‐level data, we studied the association between race/ethnicity‐specific CVD age‐adjusted mortality rate (AAMR) and county‐level factors (demographics, census region, socioeconomics, CVD risk factors, and healthcare access). Univariate and multivariable linear regressions were used to estimate the association between these factors; R 2 values were used to assess the factors that accounted for the greatest variation in CVD AAMR by race/ethnicity (non‐Hispanic White, non‐Hispanic Black, and Hispanic/Latinx individuals). There were 659 740 CVD deaths among non‐Hispanic White individuals in 2698 counties; 100 475 deaths among non‐Hispanic Black individuals in 717 counties; and 49 493 deaths among Hispanic/Latinx individuals across 267 counties. Non‐Hispanic Black individuals had the highest mean CVD AAMR (320.04 deaths per 100 000 individuals), whereas Hispanic/Latinx individuals had the lowest (168.42 deaths per 100 000 individuals). The highest CVD AAMRs across all racial/ethnic groups were observed in the South. In unadjusted analyses, the greatest variation ( R 2 ) in CVD AAMR was explained by physical inactivity for non‐Hispanic White individuals (32.3%), median household income for non‐Hispanic Black individuals (24.7%), and population size for Hispanic/Latinx individuals (28.4%). In multivariable regressions using county‐level factor categories, the greatest variation in CVD AAMR was explained by CVD risk factors for non‐Hispanic White individuals (35.3%), socioeconomic factors for non‐Hispanic Black (25.8%), and demographic factors for Hispanic/Latinx individuals (34.9%). Conclusions The associations between race/ethnicity‐specific age‐adjusted CVD mortality and county‐level factors differ significantly. Interventions to reduce disparities may benefit from being designed accordingly.

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Racial/Ethnic Disparities in Diagnoses of HIV/AIDS—33 States, 2001-2005

JAMA ◽

10.1001/jama.297.15.1647 ◽

2007 ◽

Vol 297 (15) ◽

pp. 1647 ◽

Cited By ~ 2

Keyword(s):

Ethnic Disparities ◽

Racial Ethnic ◽

Hiv Aids

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Racial/Ethnic Disparities in Diagnoses of HIV/AIDS --- 33 States, 2001--2005

PsycEXTRA Dataset ◽

10.1037/e611352007-001 ◽

2007 ◽

Keyword(s):

Ethnic Disparities ◽

Racial Ethnic ◽

Hiv Aids

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Abstract 17410: Geographic and Racial/ Ethnic Disparities in Heart Transplant Listing by County and Associated Risk Factors

Circulation ◽

10.1161/circ.142.suppl_3.17410 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Justin T Parizo ◽

Fatima Rodriguez ◽

Alexander T Sandhu ◽

Manisha Desai ◽

Kiran K Khush

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Heart Transplant ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Ethnic Disparities ◽

County Level ◽

Multivariate Models ◽

Ethnic Subgroups ◽

Racial Ethnic

Introduction: It is unknown if there are disparities in the transition from heart failure (HF) to listing for heart transplant (HT), although there are clear disparities in this transition in the transplant of other organs. Methods: We used CDC WONDER data and SRTR transplant data to identify county-level age-adjusted HF mortality and number of candidates listed for HT from 2006 to 2018 among racial/ ethnic subgroups. We determined rates of candidate listing and age-adjusted HF deaths (AAHFD) per 100,000 persons on aggregate and by racial/ ethnic subgroups. County-level demographic, socioeconomic, cardiovascular disease risk, and healthcare factors from public databases were used in multivariate models to determine factor groups explaining variation in candidates listed per AAHFD. Results: The median (IQR) candidates per AAHFD for the aggregated county cohort was 1.3 (0.75-2.0; 2558 counties reported data), the non-Hispanic white (NHW) county cohort was 1.5 (0.88-2.2; 2426 counties), the non-Hispanic black (NHB) county cohort was 1.1 (0.64-1.6; 860 counties), and the Hispanic county cohort was 1.1 (0.67-1.8; 254 counties) (p-value <0.001). The lowest candidates per AAHFD were in the South for NHW (median 1.3) and NHB (0.97), but in the West for Hispanic (0.84). Multivariate models with all county-level variables, explained (R 2 ) 28.7%, 38.7%, and 57.3% of variation in candidates listed per AAHFD for NHW, NHB, and Hispanic cohorts, respectively. Socioeconomic factors (R 2 0.14), healthcare factors (R 2 0.21), and cardiovascular disease risk factors (R 2 0.18), respectively, explained the greatest variation in models using variable subgroups. Conclusions: When age-adjusted rates of HF mortality by race/ ethnicity group is considered, HT candidate listing for NHB and Hispanic candidates is 27% lower than for NHW. County-level factors that explain variation in HT listing vary by racial/ ethnicity group, and explain more variation in NHB and Hispanic cohorts.

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