Racial and sex disparities in HIV screening outcomes within emergency departments of Harris County, Texas
Racial and sex disparities in HIV screening outcomes within emergency departments of Harris County, Texas
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DOI：
10.1002/emp2.12046
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发表时间：
2020-08-01
影响因子：
2.3
通讯作者：
McNeese, Marlene
中科院分区：
文献类型：
--
作者：
Hill, Mandy J.;Cardenas-Turanzas, Marylou;McNeese, Marlene
目的急诊科为识别未确诊的HIV病例提供机会。我们试图通过德克萨斯州哈里斯县的ED筛查来描述HIV的种族和性别流行病学，哈里斯县是美国南部最多样化和人口最多的大都市之一。方法：我们对2010-2017年普遍的HIV筛查项目进行描述性二次分析，量化HIV发病率的人口统计学差异。我们将一个经过验证的代码本应用于当地卫生部门的数据集，该数据集包含894,387份急诊科就诊记录，包含62个变量，以评估种族/民族和性别差异。结果在急诊期间接受HIV筛查的885199例（98.9%）患者中，1795例检测呈阳性（发病率= 0.2%）。在接受艾滋病毒检测的人中，大多数是白人（66.3%），其次是少数种族(非裔美国人（29.9%），亚洲人（3.6%），美洲印第安人，阿拉斯加原住民，夏威夷原住民或太平洋岛民（0.1%）。接受测试的人中有一半是西班牙裔。相反，在检测呈阳性的患者中（n = 1782，占阳性病例的99.3%），大多数是非裔美国人（52.6%），其次是白人（46.6%），亚洲人（0.7%）和当地人（0.1%）。不到一半（35.5%）的阳性患者是西班牙裔。在非洲裔美国女性中发现了艾滋病毒发病率的种族差异。这一群体占受测人群的16.8%；但在艾滋病毒检测呈阳性的女性中占65.8%，在所有艾滋病毒阳性检测结果中占20.3%。结论HIV的种族和性别流行病学的描述性发现显示，非洲裔美国女性在HIV检测人群和HIV检测阳性人群之间的差异最大。
ObjectivesThe emergency department provides opportunities for identifying undiagnosed HIV cases. We sought to describe the racial and sex epidemiology of HIV through ED screening in Harris County, Texas, one of the most diverse and populous metropolitan cities in the Southern United States.MethodsWe used a descriptive secondary analysis of a universal HIV screening program (2010-2017) to quantify demographic differences in HIV incidence. We applied a validated codebook to a dataset by the local health department containing 894,387 records of ED visits with 62 variables to assess race/ethnicity and sex differences.ResultsOf 885,199 (98.9%) patients screened for HIV during an ED visit, 1795 tested positive (incidence rate = 0.2%). Of those tested for HIV, most were White (66.3%), followed by racial minorities (African Americans (29.9%), Asians (3.6%), and American Indian, Alaska Native, Native Hawaiian or Pacific Islanders (natives) (0.1%). Half of those tested were Hispanic. Conversely, of patients testing positive (n = 1782, 99.3% of positive cases), most were African American (52.6%) followed by Whites (46.6%), Asians (0.7%), and natives (0.1%). Less than half (35.5%) of positives were Hispanic. A racial disparity in HIV incidence was discovered among African American females. This group represented 16.8% of the tested population; yet accounted for 65.8% of females who tested positive for HIV and 20.3% of all HIV-positive test results.ConclusionDescriptive findings of the racial and sex epidemiology of HIV revealed that African American females had the largest disparity between the population tested and those who tested positive for HIV.