142nd APHA Annual Meeting and Exposition

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Disparities in HIV-related hospitalizations for native Hawaiians and Asians compared to whites

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 9:10 AM - 9:30 AM

Tetine Sentell, PhD , Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI
Lisa Marten , Hawaii Department of Health, Honolulu, HI
Hyeong Jun Ahn, PhD , Biostatistics Core, University of Hawaii John A. Burns School of Medicine, Honolulu, HI
Yuanshan Qui , Hawaii Department of Health, Honolulu, HI
John J. Chen, PhD , Biostatistics Core, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI
Jill Miyamura, PhD , Hawaii Health Information Corporation, Honolulu, HI
Dominic Chow , Hawaii Center for AIDS, Honolulu
Cecilia Shikuma , Hawaii Center for AIDS, Honolulu
background: Hospitalizations by those living with HIV are expensive and often indicate a failure in access to or retention in primary care. Asian Americans and Native Hawaiians are some of the fastest growing racial/ethnic groups in the US and many members of these groups face barriers in access to health care. Higher rates of HIV hospitalizations have been reported in some U.S. ethnic minorities, yet little information is available for Native Hawaiians and Asian subgroups. Evidence suggests that HIV-related hospitalization rates may be higher in these groups than in whites.

methods: All hospitalizations in Hawaii by individuals aged >18 years from Dec 2006–Dec 2010 were considered. HIV-related hospitalizations were identified using ICD-9 diagnosis codes of 042-044 and V08 on any diagnostic field. Using Hawaii State Department of Health 2010 data, rates of HIV-related hospitalizations by ethnicity among the 2,112 Hawaii residents living with HIV were estimated along with rate ratios (using whites as the reference group). Multivariable adjusted rate ratios (aRR) were calculated with negative binomial models, adjusting for age, gender and payer type.

results: Of the 210,770 patients hospitalized, 613 had an HIV-related hospitalization. Native Hawaiians (aRR: 3.21; 95%CI: 2.11-4.88), Japanese (aRR: 2.27; 95%CI: 1.38-3.72), and Filipinos (aRR: 1.62; 1.01-2.59) living with HIV all had higher likelihood of an HIV-related hospitalization compared to whites, even when controlling for age, gender and payer. Chinese did not vary significantly from whites. Also of note, the average age of those with an HIV-related hospitalization varied significantly across groups (p<0.001), with Native Hawaiians as the youngest (45 years), followed by Filipinos (47), whites (49), Chinese (50) and Japanese (54).

conclusions: Disparities exist in HIV-related hospitalizations for Native Hawaiians and Asian subgroups.  Of particular note, Native Hawaiians are hospitalized at significantly higher rates and at younger ages than other racial/ethnic groups in Hawaii. Many Asian American and Pacific Islanders face linguistic, economic and legal barriers to HIV prevention, testing, services, and ongoing care, which may contribute to these differences in HIV-related hospitalizations. Further research is warranted to investigate and resolve these health disparities.

Learning Areas:

Administer health education strategies, interventions and programs
Diversity and culture
Program planning
Provision of health care to the public

Learning Objectives:
Identify disparities in HIV-related hospitalizations among Asian American and Pacific Islander groups compared to Whites

Keyword(s): HIV/AIDS, Asian and Pacific Islanders

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work on a number of federally-funded research projects considering disparities in hospitalizations for Asians and Pacific Islanders in Hawaii.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.