Ethnicity, Language, and HIV Screening in Older Adult Safety-Net Patients.
Ethnicity, Language, and HIV Screening in Older Adult Safety-Net Patients.
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DOI：
10.1016/j.amepre.2023.01.019
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发表时间：
2023-02
影响因子：
5.5
通讯作者：
J. Lucas;M. Marino;Roopradha Datta;Briana Chan;J. Heintzman
中科院分区：
文献类型：
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作者：
J. Lucas;M. Marino;Roopradha Datta;Briana Chan;J. Heintzman
简介 所有成年人在 65 岁之前都应至少进行一次 HIV 筛查。老年人的筛查率较低。拉丁裔的筛查率历来较低，其艾滋病毒结果比非西班牙裔白人患者更差。来自多州社区卫生中心网络的电子健康记录数据用于检查拉丁裔（首选英语和西班牙语）和非西班牙裔白人老年人的艾滋病毒筛查是否存在差异。方法数据来自 PCORnet 的全国社区卫生中心网络临床研究网络的加速数据价值，2012 年至 2021 年，对 21 个州的 50-65 岁患者进行了开放队列研究。使用广义估计方程逻辑回归模型比较拉丁裔和非西班牙裔白人，计算出曾经接受过艾滋病毒筛查的相对几率，并调整相关患者水平的协变量。分析于 2022 年进行。结果在 251,645 名患者中，偏好英语的拉丁裔患者接受 HIV 筛查的协变量调整几率比非西班牙裔白人高 18%（OR=1.18, 95% CI=1.11, 1.25），偏好西班牙语的拉丁裔患者比非西班牙裔白人高 32%（OR=1.32, 95%） CI=1.24, 1.42)。 结论 在社区卫生中心就诊的拉丁裔，无论说什么语言，都比非西班牙裔白人更有可能接受至少一次艾滋病毒筛查。这种筛查的增加可能至少部分归因于社区卫生中心的设置（众所周知，这种设置可以减少差异），以及社区卫生中心参与公共卫生运动的努力。未来的研究可以优先了解这种相对优势的原因。
IntroductionHIV screening should occur for all adults at least once by age 65 years. Older adults have low screening rates. Latinos, with historically low screening rates, have worse HIV outcomes than non-Hispanic White patients. Electronic health record data from a multistate network of community health centers were used to examine whether there are differences in HIV screening for Latino (English and Spanish preferring) and non-Hispanic White older adults.MethodsData were from the Accelerating Data Value Across a National Community Health Center Network Clinical Research Network of PCORnet from 21 states in 2012–2021 among an open cohort of patients aged 50–65 years. Relative odds of ever having received HIV screening comparing Latinos with non-Hispanic Whites using generalized estimating equation logistic regression modeling were calculated, adjusting for relevant patient-level covariates. Analyses were conducted in 2022.ResultsAmong 251,645 patients, the covariate-adjusted odds of ever receiving HIV screening were 18% higher for English-preferring Latino patients (OR=1.18, 95% CI=1.11, 1.25) and 32% higher for Spanish-preferring Latinos than for non-Hispanic Whites (OR=1.32, 95% CI=1.24, 1.42).ConclusionsLatinos seen in community health centers, regardless of language spoken, are more likely to be screened at least once for HIV than non-Hispanic Whites. This increased screening may be due at least in part to the community health center setting, a setting known to mitigate disparities, as well as due to participation efforts by community health centers in public health campaigns. Future research can prioritize understanding the cause of this relative advantage.