Document Type



Doctor of Philosophy (PhD)


Public Health

First Advisor's Name

Mary Jo Trepka

First Advisor's Committee Title

Committee chair

Second Advisor's Name

Kristopher P. Fennie

Second Advisor's Committee Title

Committee member

Third Advisor's Name

Frank R. Dillon

Third Advisor's Committee Title

Committee member

Fourth Advisor's Name

Purnima Madhivanan

Fourth Advisor's Committee Title

Committee member


human immunodeficiency virus, Latino, Hispanic, neighborhood, survival, delayed diagnosis

Date of Defense



The purpose of this study was to estimate disparities in late human immunodeficiency virus (HIV) diagnosis and all-cause mortality among varying populations of HIV-positive Latinos, and to identify neighborhood-level predictors. Florida HIV surveillance data for years 2000–2011 were merged with 2007–2011 American Community Survey (ACS) data. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR) for late HIV diagnosis (acquired immunodeficiency syndrome within 3 months of HIV diagnosis). Multilevel weighted Cox regressions were used to estimate adjusted hazard ratios (aHR) for mortality. Of 5522 Latinos diagnosed 2007–2011, males were at increased odds of late diagnosis compared with females (aOR 1.37, 95% confidence interval [CI] 1.13-1.67). Associated factors included residing in the lowest quartile of neighborhood education for females, and in the 3 highest quartiles of unemployment for males. Foreign-born compared with United States (US)-born Latinos were also at risk (aOR 1.24, 95% CI 1.08-1.42). Among foreign-born, residing in areas with



Included in

Epidemiology Commons



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