Racial/ethnic disparities in delayed HIV diagnosis among men who have sex with men, Florida, 2000–2014

ABSTRACT

Only about 85% of men who have sex with men (MSM) with human immunodeficiency virus (HIV) have been tested for and diagnosed with HIV. Racial/ethnic disparities in HIV risk and HIV care outcomes exist within MSM. We examined racial/ethnic disparities in delayed HIV diagnosis among MSM. Males aged ≥13 reported to the Florida Enhanced HIV/AIDS Reporting System 2000–2014 with a reported HIV transmission mode of MSM were analyzed. We defined delayed HIV diagnosis as an AIDS diagnosis within three months of the HIV diagnosis. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR). Of 39,301 MSM, 27% were diagnosed late. After controlling for individual factors, neighborhood socioeconomic status, and rural–urban residence, non-Latino Black MSM had higher odds of delayed diagnosis compared with non-Latino White MSM (aOR 1.15, 95% confidence interval [CI] 1.08–1.23). Foreign birth compared with US birth was a risk factor for Black MSM (aOR 1.27, 95% CI 1.12–1.44), but a protective factor for White MSM (aOR 0.77, 95% CI 0.68–0.87). Rural residence was a risk for Black MSM (aOR 1.79, 95% CI 1.36–2.35) and Latino MSM (aOR 1.87, 95% CI 1.24–2.84), but not for White MSM (aOR 1.26, 95% CI 0.99–1.60). HIV testing barriers particularly affect non-Latino Black MSM. Social and/or structural barriers to testing in rural communities may be significantly contributing to delayed HIV diagnosis among minority MSM.

KEYWORDS:

• Human immunodeficiency virus
• men who have sex with men
• late diagnosis
• neighborhood

Acknowledgements

The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA, NIMHD, or the National Institutes of Health.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Drug Abuse (NIDA) [award number F31DA037790] and by the National Institute on Minority Health & Health Disparities (NIMHD) [award number R01MD004002].