In a study of HIV-infected patients at Harris Health System’s Thomas Street Health Center, researchers at Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center found that undocumented Hispanic patients were likely to seek treatment at a more advanced stage of HIV than other patients. They also found that once these patients entered care, their outcomes were the same or even better than other patients. Their report appears in this week in PLOS ONE.
"This finding is important for the individual patient but also has significant public health implications," said Dr. Thomas Giordano, associate professor of medicine - infectious diseases at BCM and senior author of the paper. Giordano is also with the Houston VA Health Services Research and Development Center of Excellence at the DeBakey VA Medical Center.
Giordano and colleagues reviewed data from patients who visited Thomas Street over a five-and-a-half year period. The study consisted of 1,620 HIV-infected adults, including 186 undocumented Hispanic patients, 278 documented Hispanic patients, 986 black patients and 170 white patients.
"We found that undocumented Hispanic patients came into the clinic with the most advanced HIV disease compared to the documented Hispanic, black and white populations, indicating that they were delaying care or had experienced delays in getting diagnosed," said Giordano. "Once they did enter care, they actually did just as well or better than the other populations in the study in terms of staying in care and getting their HIV under control, which is the best outcome we strive for given our current medications."
Previous research has shown that the undocumented Hispanic population is fearful of reaching out for publically funded healthcare because they fear there might be some ramifications for them, Giordano said. Thomas Street cares for patients regardless of their citizenship or their ability to pay.
Shows program working
"This shows us that programs that are designed to care for people regardless of their financial or immigration status are working, which has a very important public health benefit, because the more people you have with HIV who are in control of their disease, the less transmission there’s going to be of HIV in the community as a whole. The intent of these programs is to provide care to both the individual as well as protect the public, and our research shows this is working," he said.
Giordano said the next steps would be to try to see why this population of patients presents later, but still does so well in managing their HIV. He added that there needs to be additional research to better understand HIV outcomes of Hispanics based on their country of origin as well as whether there are differences in the documented Hispanic population based on acculturation status, or how long they or their families have been in the United States.
Others who took part in the study include Dr. Kenneth K. Poon, now with the Broward Community and Family Health Centers in Florida, Dr. Bich N. Dang, Dr. Jessica A. Davila and Dr. Christine Hartman of BCM and the DeBakey VA.
Funding for this study was made possible by the resources at Harris Health and the DeBakey VA.