Unequal Declines in Absolute and Relative Disparities in HIV Diagnoses Among Black Women, United States, 2008 to 2016

Abstract

Objectives. To assess changes in disparities of HIV diagnosis rates among Black women aged 18 years or older living in the United States. Methods. We calculated estimated annual percent changes (EAPCs) in annual diagnosis rates, rate differences (absolute disparity), and rate ratios (relative disparity) for groups (total, US-born, and non–US-born) of Black women (referent was all White women) with diagnosed HIV infection, using data reported to the National HIV Surveillance System. Results. Of 39 333 Black women who received an HIV diagnosis during 2008 to 2016, 21.4% were non–US-born. HIV diagnosis rates declined among all Black women, with the smallest decline among non–US-born groups (EAPC = –3.1; P ≤ .001). Absolute disparities declined for both US-born and non–US-born Black women; however, the relative disparity declined for Black women overall and US-born Black women, whereas it increased for non–US-born (including Caribbean- and Africa-born) Black women. Conclusions. Differences in disparities in HIV diagnoses exist between US-, and non–US-born (specifically Caribbean- and Africa-born) Black women. Accounting for the heterogeneity of the Black women’s population is crucial in measuring and monitoring progress toward eliminating health disparities among Black women.