AIDS survival among latinos: Disparities by country/region of birth

Background: The objective of this study was to describe survival patterns among Latinos diagnosed with acquired immunodeficiency syndrome (AIDS) between the years 1996 – 2004 and reported to the Florida human immunodeficiency virus/AIDS surveillance system. Methods: Vital status was ascertained by linkage with Florida Vital Records, the Social Security Death Master File and the National Death Index. Data were analyzed in SAS. Weighted Cox Regression was used to address non-proportionality. Adjusted hazard ratios (AHR) were calculated for race/ethnic group and for Latinos (of any race) by country/region of birth. Race/ethnic AHR were controlled for gender, age, transmission category, and year of diagnosis. Results: Of 44,608 individuals diagnosed with AIDS, 16,997 died between 1996-2007. Included were 7,421 Latinos of whom 31.9% (2,368) died. Among Latinos, 668 (9%) cases were missing country of birth information. There was no difference in survival between United States (U.S.)-born Latinos and U.S.-born non-Latino whites (AHR: 0.94 [95% CI 0.84-1.05]). When compared to U.S.-born Latinos, shorter survival was associated with being born in Cuba (AHR: 1.42 [95% CI 1.21-1.66]); and Puerto Rico (AHR: 1.31 [95% CI 1.13-1.52]). Longer survival was associated with being born in South America (AHR: 0.67 [95% CI 0.53-0.86]). Conclusions: AIDS survival among U.S.-born Latinos living in Florida is similar to U.S-born non-Latino whites. Significant differences exist among foreign-born Latinos when compared to U.S.-born Latinos that persist after controlling for relevant confounders.