Neighborhood Latino ethnic density and mortality among HIV-positive Latinos by birth country/region, Florida, 2005-2008

Ethn Health. 2016;21(3):268-83. doi: 10.1080/13557858.2015.1061104. Epub 2015 Jul 10.


Objective: Lower mortality for Latinos has been reported in high Latino density areas. The objective was to examine the contribution of neighborhood Latino density to mortality among HIV-positive Latinos.

Methods: Florida HIV surveillance data for 2005-2008 were merged with the 2007-2011 American Community Survey data using zip code tabulation areas. Hazard ratios (HR) were calculated using multi-level weighted Cox regression and adjusted for individual-level factors and neighborhood poverty.

Results: Of 4649 HIV-positive Latinos, 11.8% died. There was no difference in mortality risk across categories of Latino ethnic density for Latinos as a whole. There were subgroup effects wherein mortality risk differed by ethnic density category for Latinos born in some countries/regions. Residing in an area with ≥50% Latinos compared with <25% was associated with increased mortality risk for Latinos born in Puerto Rico (HR 1.67; 95% confidence interval [CI] [1.01-2.70]). Residing in an area where Mexicans were the majority Latino group was associated with increased mortality risk for Latinos born in Mexico (HR 3.57; 95% CI [1.43-10.00]).

Conclusions: The survival advantage seen among the Latino population in high Latino density areas was not seen among HIV-positive Latinos. Research is needed to determine if this may be related to stigma or another mechanism.

Keywords: Latino; ethnic density; human immunodeficiency virus; mortality; neighborhood.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Florida / epidemiology
  • HIV Infections / ethnology*
  • HIV Infections / mortality*
  • Humans
  • Male
  • Mexican Americans / statistics & numerical data*
  • Mexico / ethnology
  • Middle Aged
  • Poverty
  • Puerto Rico / ethnology
  • Residence Characteristics / statistics & numerical data*
  • Risk Factors
  • Young Adult