1. Demographic and Behavioral Differences between Latino and non-Latino Patients Attending Baltimore City STD Clinics, 2002-2007 Renee M. Gindi 1, Kathleen R. Page 2, Laura Herrera 3, Emily J. Erbelding 2 1 Johns Hopkins School of Public Health, Baltimore 2 Johns Hopkins University School of Medicine 3 Baltimore City Health Department, Baltimore © 2006, Johns Hopkins University. All rights reserved.

2. © 2005, Johns Hopkins University. All rights reserved. CDC. Slide Sets: HIV/AIDS Surveillance by Race/Ethnicity (through 2005)

3. © 2005, Johns Hopkins University. All rights reserved. CDC. STD Surveillance, 2006. Atlanta, GA: U.S. DHHS, November 2007. Racial/Ethnic Disparities in Sexually Transmitted Diseases, 2006

4. © 2005, Johns Hopkins University. All rights reserved. Percent of Foreign Born Who Entered 1990 to 2000 by State: 2000 Prepared with American FactFinder Population Research Center. A Profile of the U.S. Foreign-Born Population. December 9, 2003.

5. © 2005, Johns Hopkins University. All rights reserved. Summary characteristics of reviewed studies of HIV/STD infection and risk factors among Latino migrants in rapid growth states of the South © 2006, Johns Hopkins University. All rights reserved. Painter, TM. AIDS and Behavior, 2007. Supplementary Table. Study characteristics Number of studies, range if applicable Studies of urban-based migrants (Number of studies, median sample size, sample size range)3 (173; 43-442) Studies of migrant and seasonal farm workers7 (198; 9-2966) Studies that screened for infection5 Studies that described risk factors 2 Studies that did not describe risk factors 3 Studies that did not screen for infection5 Studies that described risk factors 5 Studies that did not describe risk factors 0

6. © 2005, Johns Hopkins University. All rights reserved. Methods Electronic medical records were examined from the first visit for all patients attending two Baltimore City Health Department STD Clinics between 2002-2007. Hispanic ethnicity, and other social and behavioral characteristics were self-reported. –Sexual preference, condom use, contraceptives, drug use, partner risk factors STD/HIV diagnoses (gonorrhea, chlamydia, syphilis, and HIV) were documented by clinicians after laboratory testing. Chi-square analysis and multivariate logistic regression were used to test for differences in STD diagnoses, demographic factors, and risk factors between Latino and non-Latino patients. © 2006, Johns Hopkins University. All rights reserved.

7. © 2005, Johns Hopkins University. All rights reserved. Characteristics of the Study Population © 2006, Johns Hopkins University. All rights reserved. Sexual preference *

8. © 2005, Johns Hopkins University. All rights reserved. Risk Factor Prevalence among Males * ** * *

9. © 2005, Johns Hopkins University. All rights reserved. Risk Factor Prevalence among Females *** *

10. © 2005, Johns Hopkins University. All rights reserved. Infection Prevalence among Males * * * *

11. © 2005, Johns Hopkins University. All rights reserved. Infection Prevalence among Females ***

12. © 2005, Johns Hopkins University. All rights reserved. Predictors of Infection

13. © 2005, Johns Hopkins University. All rights reserved. Discussion Ethnic disparities in STI persist even after adjusting for demographics, sexual behaviors, and substance use. Other work in the racial disparities field suggests network- level explanations. Differences between GC and Syphilis support a network-level explanation. © 2006, Johns Hopkins University. All rights reserved.

14. © 2005, Johns Hopkins University. All rights reserved. Discussion Limitations Clinical database Retrospective review Convenience sample Migrant status not assessed Strengths Standard form has had comparable variables since 2002 Samples a high-risk clinic- attending population Important addition to studies of STD/HIV risk among Latinos in the southeastern US

15. © 2005, Johns Hopkins University. All rights reserved. Conclusions Latino STD clinic patients are less likely to have traditional sexual and behavioral risk behaviors than non-Latino patients. Latino STD clinic patients may be at risk for different infections than non-Latino clinic patients, based on network- level prevalence of these infections. A thorough understanding of circumstances contributing to risk may help shape appropriate counseling strategies and interventions. © 2006, Johns Hopkins University. All rights reserved.

16. © 2005, Johns Hopkins University. All rights reserved. Questions? Renee M Gindi, MPH rgindi@jhsph.edu

17. © 2005, Johns Hopkins University. All rights reserved.

18. Predictors of Infection