Disparities in hospitalizations among HIV positive individuals for Native Hawaiians and Asians compared to Whites in Hawai'i.

Hospitalizations of those living with HIV are expensive and often indicate failures in access to, or retention in, primary care. Higher rates of hospitalizations among individuals with HIV have been reported in some US ethnic minorities, yet little information is available for Native Hawaiians and Asian subgroups. All hospitalizations in Hawai'i of individuals aged ≥13 years from December 2006-December 2010 were considered. Hospitalizations of individuals with HIV were identified using ICD-9 diagnosis codes of 042 and V08; 613 hospitalizations with an HIV diagnostic code were found. Using Hawaii State Department of Health 2010 data, estimated rates of hospitalizations among HIV positive individuals by race/ethnicity among the 2,600 Hawai'i residents living with HIV were calculated along with estimated rate ratios (using Whites as the reference group). Multivariable adjusted estimated rate ratios (aRR) were calculated with negative binomial models, adjusting for age, sex, and payer type. Demographic and clinical differences among hospitalized patients with HIV were also compared by race/ethnicity. Native Hawaiians (aRR: 3.21; 95%CI: 2.11-4.88), Japanese (aRR: 2.27; 95%CI: 1.38-3.72), and Filipinos (aRR: 1.62; 95%CI: 1.01-2.59) living with HIV all had higher likelihood of a hospitalization compared to Whites, even when controlling for age, sex, and payer. Chinese did not vary significantly from Whites. Also of note, the average age of HIV positive individuals who were hospitalized varied significantly across groups (P-value < .001), with Native Hawaiians as the youngest (45 years), followed by Filipinos (47 years), Whites (49 years), Chinese (50 years) and Japanese (54 years). Disparities appear to exist in hospitalizations among HIV positive individuals for Native Hawaiians and Asian subgroups. Further research is warranted to investigate the reasons for these health disparities.