New Diagnoses among HIV+ Men and Women in Puerto Rico: Data from the HIV Surveillance System 2003-2014.

Colón-López V, Miranda-De León S, Machin-Rivera M, Soto-Abreu R, Marrero-Cajigas EL, Rolón-Colón Y, Valencia-Torres IM, Suárez-Pérez EL

Abstract

OBJECTIVE:
Describe the age-standardized rates of new HIV diagnoses and compare sex and time disparities using data from the HIV/AIDS Surveillance System in Puerto Rico (PR).

METHODS:
The study comprises data of new HIV diagnoses of persons 13 years of age and older in PR reported from 2003-2014. Other variables included were age, sex, and health regions. We computed male to female ratio of new HIV diagnoses and assessed the trends in new HIV diagnoses using the annual percent change (APC) of the age-standardized rates (ASRs). The relative risk (RR) was estimated with 95% confidence intervals using Poisson regression models to assess the risk of new HIV diagnoses.

RESULTS:
The highest HIV diagnosis rates were observed in the metropolitan area. These rates decreased overall for both sexes for the periods 2007 onward. The risk of getting a new HIV diagnosis was significantly higher among males, ranging from an increased risk of more than 50% to almost 5-fold (p<0.05). Overall, a trend was observed in the 2011-2014 period were the risk increases as the age decreases. For the 13-24 age group, we observed a significant increased risk in new HIV diagnosis of 53% in the 2011-2014 period, when compared to 2003-2006 (p<0.05).

CONCLUSION:
Our findings suggest a shift in the risk of getting a HIV diagnosis from older to younger males. A possible explanation could be that HIV spread among young men that have sex with men might be increasing. Targeted prevention strategies should be implemented in this age group.

KEYWORDS:
Epidemiology; HIV; Health Disparities; PR; Surveillance System