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Human Immunodeficiency Virus

1. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras, and Daryle Lamonica University of Massachusetts Medical School Summer Enrichment Program 2019.

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Human Immunodeficiency Virus

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  1. 1 Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras, and Daryle Lamonica University of Massachusetts Medical School Summer Enrichment Program 2019 Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  2. 2 Human Immunodeficiency Virus • Human Immunodeficiency Virus (HIV): • Destroys T Cells responsible for combating infections • Develops into AIDS if untreated • Currently incurable • Acquired Immunodeficiency Syndrome (AIDS): • Final stage of HIV infection • Consequences: • Depressed immune system • Higher risk of infection and cancer Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  3. 3 HIV Disparity Among Hispanic/Latino Population • Health Disparity: • Difference in incidence, prevalence, mortality, and burden of adverse health conditions among specific population groups in the US, when compared in contrast to general population • Prevalence: • The proportion of a population who have a specific characteristic in a given time period • Hispanic/Latino: • Refers to any individual who is from a spanish speaking country or a country of latin decent • Our Focus: • Disparity in prevalence of HIV amongst Hispanic/Latinos compared to general population Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  4. 4 Contrast in Prevalence of HIV Between MA & National Average “AtlasPlus | NCHHSTP | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/nchhstp/atlas/index.htm. “AtlasPlus | NCHHSTP | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/nchhstp/atlas/index.htm. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  5. 5 Social Determinants of Health • Circumstances in which people grow up, live, work, age • Systems that provide healthcare and community services • Shaped by economics, social policies, and politics “Let's Start A Conversation About Social Determinants of Health.” Integra Service Connect, 8 Aug. 2018, integraserviceconnect.com/lets-start-conversation-social-determinants-health/.

  6. 6 Cause of Disparity in Massachusetts • Higher infection rates and prevalence stemming from intravenous drug use • Poor access to healthcare due to economic class • StigmaAgainst HIV screening and healthcare Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  7. 7 Intravenous Drug Use and HIV • The risk for getting or transmitting HIV is very high if a person uses injection equipment that someone living with HIV has used • The HIV virus can survive in a used needle for up to 42 days • Misuse of drugs can lead to riskier sexual behavior Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  8. 8 Connection Between Drug Use and HIV • Individuals diagnosed with HIV infection who inject drugs increased to 50% in 2015 and 67% in 2016. • Intravenous drug use is one of the leading transmission categories for the Hispanic/Latino population “AtlasPlus | NCHHSTP | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/nchhstp/atlas/index.htm. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  9. Injection Related HIV Prevalence 9 • Higher prevalence observed amongst Hispanic/Latino population compared to the general population. • Disproportionately affected by intravenous drug use compared to the general population. “AtlasPlus | NCHHSTP | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/nchhstp/atlas/index.htm. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  10. 10 Economic Status By Race/Ethnicity • Economic disparity present among Latinos in MA • Low income is correlated with lack of health insurance US Census Bureau. 2015 American Community Survey 1-Year Estimates, S1902 File, Massachusetts. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  11. 11 Health Insurance Coverage in Massachusetts Uninsured MA Residents by Race/Ethnicity • Most insured state in the nation • Disparity in healthcare coverage amongst Hispanics/Latinos • Strong correlation between being uninsured and obtaining HIV Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  12. 12 Consequences of Being Uninsured Compared to General Population: • Less likely to receive primary and preventative care services • Far fewer emergency room and urgent care visits • 37% more likely to wait more than 3 months to be seen post HIV diagnosis • Less likely to receive highly effective medications shown to improve survival Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  13. 13 HIV Stigma among Hispanic Population “HIV Stigma and Discrimination.” AVERT, Avert , 9 Apr. 2018, www.avert.org/professionals/hiv-social-issues/stigma-discrimination#footnote13_1806s5z. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  14. 14 HIV Stigma & Effect on Treatment • Associated with homosexuality & drug use • Fears of deportation • Social withdrawal due to HIV Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  15. 15 Suggested Intervention Methods • Community Involvement • Hector Reyes House, Worcester, MA • Community advocates • Volunteering • Policy Changes • Needle Exchange • Community Health Center Funding • Education on HIV prevention “The Hector Reyes House | Worcester, MA.” Hector Reyes House, www.lahaworc.org/. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  16. 16 Conclusion • Hispanics/Latinos are disproportionately more likely to be living with HIV compared to the general population • The disproportionate amount Hispanics/Latinos with HIV is caused by drug use, economic status, and stigma • There are different avenues of attack as to reduce this disparity. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  17. 17 Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

  18. 18 Works Cited • CDC. “What Are HIV and AIDS?” HIV.gov, 21 Feb. 2018, www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids. • Institute of Medicine (US) Committee on the Consequences of Uninsurance. “Effects of Health Insurance on Health.” Care Without Coverage: Too Little, Too Late., U.S. National Library of Medicine, 1 Jan. 1970, www.ncbi.nlm.nih.gov/books/NBK220636/. • “Comprehensive, up-to-Date Information on HIV/AIDS Treatment and Prevention from the University of California San Francisco.” Latinos and HIV: Cultural Issues in AIDS Prevention, hivinsite.ucsf.edu/InSite?page=pr-rr-03#S4.2X. • Levison, Julie H., et al. “‘Where It Falls Apart’: Barriers to Retention in HIV Care in Latino Immigrants and Migrants.” AIDS Patient Care & STDs, vol. 31, no. 9, Sept. 2017, pp. 394–405. EBSCOhost, doi:10.1089/apc.2017.0084. • Massachusetts Department of Public Health. Massachusetts State Health Assessment. Boston, MA; October 2017. • “AtlasPlus | NCHHSTP | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/nchhstp/atlas/index.htm. • Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014. • “Demographic and Economic Profiles of Hispanics by State and County, 2014.” Pew Research Center's Hispanic Trends Project, Pew Research Center, www.pewhispanic.org/states/state/ma/. • Sayles, Jennifer N et al. “The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS.” Journal of general internal medicine vol. 24,10 (2009): 1101-8. doi:10.1007/s11606-009-1068-8 • “HIV Stigma and Discrimination.” AVERT, Avert , 9 Apr. 2018, www.avert.org/professionals/hiv-social-issues/stigma-discrimination#footnote13_1806s5z. • Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory Sciences. 2018 Massachusetts HIV/AIDS Epidemiologic Profile, Detailed Data Tables and Technical Notes: The Massachusetts HIV/AIDS Epidemic at a Glancehttps://www.mass.gov/lists/hivaids-epidemiologic-profiles Published June 2018. Accessed May 31, 2019. • Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory Sciences. 2018 Massachusetts HIV/AIDS Epidemiologic Profile: Executive Summaryhttps://www.mass.gov/lists/hivaids-epidemiologic-profiles Published September 2018. Accessed May 31, 2019. • Meyers DJ, Hood ME, Stopka TJ (2014) HIV and Hepatitis C Mortality in Massachusetts, 2002–2011: Spatial Cluster and Trend Analysis of HIV and HCV Using Multiple Cause of Death. PLOS ONE 9(12): e114822.https://doi.org/10.1371/journal.pone.0114822 • “What Is Prevalence?” National Institute of Mental Health, U.S. Department of Health and Human Services, www.nimh.nih.gov/health/statistics/what-is-prevalence.shtml. • HISPANICS/LATINOS & HIV/AIDS. 2014, www.latinoaids.org/publications/HispanicsHIV2014.pdf. • “Let's Start A Conversation About Social Determinants of Health.” Integra Service Connect, 8 Aug. 2018, integraserviceconnect.com/lets-start-conversation-social-determinants-health/. Prevalence of HIV Amongst the Hispanic/Latino Population Compared to the General Population in Massachusetts Andrea Shehaj, Dominick Taveras and Daryle Lamonica

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