HIV Diagnosis Disparities in US-Born vs Non-US-Born Black Women
Accounting for the heterogeneity of the black women's population is crucial in measuring and monitoring progress toward eliminating health disparities among black women.
Although HIV diagnoses among black women have declined since 2008, there are disparities between black women who are born in the United States and black women who were not, according to results published in the American Journal of Public Health.
These disparities are particularly notable among black women born in the Caribbean and Africa.
The researchers used data reported to the National HIV Surveillance System to calculate estimated annual percentage changes (EAPCs) in annual diagnosis rates, rate differences (absolute disparity), and rate ratios (relative disparity) for groups (total, US-born, and non-US-born) of black women (referent was all white women) with diagnosed HIV infection.
From 2008 to 2016, the researchers found that the HIV diagnosis rate declined among all white women, going from 1.7/100,000 to 1.1/100,000 population (EAPC, −5.6; 95% CI, −7.4 to −3.9; P ≤.001), compared with a decrease from 42.7/100,000 to 20.4/100,000 among all black women (EAPC, −9.6; 95% CI, −10.4 to −8.7; P ≤.001).
Between 2008 and 2016, 39,333 black women received a diagnosis of HIV. Of these, 21.4% were not born in the United States.
From 2008 to 2017, HIV diagnosis rates declined among all black women. The smallest decline was seen among groups of women who were not born in the United States, dropping from 67.5/100,000 to 54.4/100,000 (EAPC, −3.1; P ≤.001).
The researchers found that absolute disparities decline for both US-born and non-US-born black women. However, they also found that the relative disparity declined for all black women and black women born in the United States, whereas it increased for black women who were not born in the United States.
"Accounting for the heterogeneity of the Black women's population is crucial in measuring and monitoring progress toward eliminating health disparities among Black women," the researchers wrote.
Demeke HB, Johnson AS, Wu B, et al. Unequal declines in absolute and relative disparities in HIV diagnoses among black women, United States, 2008 to 2016 [published online November 1, 2018]. Am J Public Health. doi: 10.2105/AJPH.2018.304641