{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T01:12:03Z","timestamp":1781745123384,"version":"3.54.5"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006735","name":"New York City Health and Hospitals Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Racial disparities, an imbalance between the treatment of racial groups, in healthcare significantly affect the prognosis and treatment outcomes for people living with HIV (PLHIV) and heart failure (HF). The complexity of racial disparities in health care is exacerbated when social determinants of health (SDoH). Utilizing the New York City Health and Hospitals HIV Heart Failure (NYC 4H) cohort, one of the largest public health providers in New York City, this study aims to describe the epidemiological characteristics, treatment, and mortality differences among various racial groups in patients living with HIV (PLHIV) and HF.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study utilized data from the mixed retrospective and prospective NYC 4H cohort, comprised of adult individuals with confirmed HIV and HF from inpatient or clinic visits between July 2017 and June 2022.<\/jats:p>\n from eleven major New York City Health and Hospitals. Racial identification was reported by the patients. Social adversities (SA) were assessed through a psychosocial evaluation conducted by licensed clinical social workers (LCSWs) during the initial clinic or hospital encounter within the enrollment period. Each patient\u2019s home address was mapped to the area deprivation index (ADI) to obtain ADI ranking and further characterize socioeconomic disadvantage. We assessed the relationship between social adversities and overall mortality in each racial group using hazard ratios (HRs) derived from proportional hazard regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 1044 patients, including 631 Black\/African American, 289 Hispanic\/Latino, 57 non-Hispanic White, 17 Asian\/Pacific Islander, and 50 of unknown or other racial backgrounds were analyzed in the study. An average follow-up time is 3.8 years. Significant racial difference in ischemic cardiomyopathy, with the highest occurrence found in the Black\/African American group (51%) were noticed comparing to Asian\/Pacific Islander (2.3%) and Other\/Unknown groups (5.6%) (P\u2009<\u20090.001). The rate of coronary artery bypass grafting (CABG) among the African American population (1.9%) is notably lower (P\u2009<\u20090.001) compared to other racial groups. Based on state-wide ADI ranking, all patients disproportionately clustered in the most disadvantaged neighborhood areas, however patients identifying as Black\/African American and Hispanic\/Latino were more likely to reside in areas with higher ADI score. Asian\/Pacific Islander populations have experienced fewer social adversities, with 76.5% reporting no encounters with social adversity, compared to 41% for Black\/African American, 44.3% for Hispanic\/Latino, 45.6% for non-Hispanic White, and 34% for Other\/Unknown groups\n .<\/jats:bold>\n Non-Hispanic White group exhibited a higher prevalence of LGBTQ individuals at 10.5%, a identity not commonly listed among the top challenge for other racial groups (P\u2009=\u20090.002). During the follow-up period, a total of 259 deaths were recorded. The mortality rate is lowest in Asian\/Pacific Islanders (11.8%), while comparing to non-Hispanic Whites (33.3%) and unknown or other races (50%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Significant differences exist in comorbidities, disease management, and social conditions among HIV and heart failure patients across five racial groups. The findings suggest that within impoverished multiethnic communities, it is crucial to conduct comprehensive screenings for social adversities across all racial groups, as social disadvantage may manifest in various ways.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0343710","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T17:29:51Z","timestamp":1773077391000},"page":"e0343710","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Racial differences in people living with HIV and Heart Failure: Insight from New York City health and hospitals HIV Heart Failure Cohort"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-6545","authenticated-orcid":true,"given":"Pawel","family":"Borkowski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Biavati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Nazarenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Parker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrin","family":"Kharawala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Vargas-Pena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivang","family":"Bhakta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishmum","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibhor","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Faillace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Palaiodimos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6762-6342","authenticated-orcid":true,"given":"Yi-Yun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"pone.0343710.ref001","author":"Organization WH"},{"issue":"17","key":"pone.0343710.ref002","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"G Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"issue":"9","key":"pone.0343710.ref003","doi-asserted-by":"crossref","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics-2020 update: a report from the american heart association","volume":"141","author":"SS Virani","year":"2020","journal-title":"Circulation"},{"issue":"9","key":"pone.0343710.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0257583","article-title":"Racial and ethnic disparities in HIV diagnoses among heterosexually active persons in the United States nationally and by state, 2018","volume":"16","author":"EG Martin","year":"2021","journal-title":"PLoS One"},{"issue":"3","key":"pone.0343710.ref005","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1097\/HCO.0000000000000855","article-title":"Racial and ethnic disparities in heart failure: current state and future directions","volume":"36","author":"SC Lewsey","year":"2021","journal-title":"Curr Opin Cardiol"},{"issue":"2","key":"pone.0343710.ref006","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.pcad.2020.02.006","article-title":"Prevention of cardiovascular disease for historically marginalized racial and ethnic groups living with HIV: A narrative review of the literature","volume":"63","author":"C Muiruri","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"issue":"1","key":"pone.0343710.ref007","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/s12939-023-01992-6","article-title":"Understanding why racial\/ethnic inequities along the HIV care continuum persist in the United States: a qualitative exploration of systemic barriers from the perspectives of African American\/Black and Latino persons living with HIV","volume":"22","author":"P Filippone","year":"2023","journal-title":"Int J Equity Health"},{"issue":"5","key":"pone.0343710.ref008","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1001\/jamacardio.2017.0264","article-title":"Association between HIV infection and the risk of heart failure with reduced ejection fraction and preserved ejection fraction in the antiretroviral therapy era: results from the veterans aging cohort study","volume":"2","author":"MS Freiberg","year":"2017","journal-title":"JAMA Cardiol"},{"issue":"3","key":"pone.0343710.ref009","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1600-0897.2010.00962.x","article-title":"Biological factors that may contribute to regional and racial disparities in HIV prevalence","volume":"65","author":"R Kaul","year":"2011","journal-title":"Am J Reprod Immunol"},{"issue":"7","key":"pone.0343710.ref010","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1089\/apc.2009.0288","article-title":"Trust in physicians and racial disparities in HIV care","volume":"24","author":"S Saha","year":"2010","journal-title":"AIDS Patient Care STDS"},{"issue":"4","key":"pone.0343710.ref011","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1093\/aje\/kwy230","article-title":"Addressing Gaps in HIV preexposure prophylaxis care to reduce racial disparities in HIV incidence in the United States","volume":"188","author":"SM Jenness","year":"2019","journal-title":"Am J Epidemiol"},{"key":"pone.0343710.ref012","first-page":"100554","article-title":"The effects of social determinants of health on acquired immune deficiency syndrome in a low-income population of Brazil: a retrospective cohort study of 28.3 million individuals","volume":"24","author":"I Lua","year":"2023","journal-title":"Lancet Reg Health Am"},{"issue":"3","key":"pone.0343710.ref013","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.026590","article-title":"Influence of social determinants of health on heart failure outcomes: a systematic review","volume":"12","author":"KR Enard","year":"2023","journal-title":"J Am Heart Assoc"},{"issue":"10","key":"pone.0343710.ref014","article-title":"Demographic and clinical characteristics of New York City Health + Hospitals HIV Heart Failure (NYC4H cohort): cohort profile","volume":"14","author":"Y-Y Chen","year":"2024","journal-title":"BMJ Open"},{"issue":"4","key":"pone.0343710.ref015","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/hiv.13760","article-title":"Weight and mortality in people living with HIV and heart failure: Obesity paradox in the era of glucagon-like peptide 1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors","volume":"26","author":"N Nazarenko","year":"2025","journal-title":"HIV Med"},{"issue":"7","key":"pone.0343710.ref016","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.2105\/AJPH.93.7.1137","article-title":"Area deprivation and widening inequalities in US mortality, 1969-1998","volume":"93","author":"GK Singh","year":"2003","journal-title":"Am J Public Health"},{"issue":"1","key":"pone.0343710.ref017","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12939-021-01616-x","article-title":"A scoping review of inequities in access to organ transplant in the United States","volume":"21","author":"C Park","year":"2022","journal-title":"Int J Equity Health"},{"issue":"4","key":"pone.0343710.ref018","article-title":"Association of socioeconomic position with racial and ethnic disparities in survival after lung transplant","volume":"6","author":"CJ Lehr","year":"2023","journal-title":"JAMA Netw Open"},{"key":"pone.0343710.ref019","author":"Prevention CF, CfDCa","year":"2023"},{"key":"pone.0343710.ref020","author":"Centers for Disease Control and Prevention","year":"2023"},{"issue":"8","key":"pone.0343710.ref021","article-title":"Heart disease and stroke statistics-2023 update: a report from the american heart association","volume":"147","author":"CW Tsao","year":"2023","journal-title":"Circulation"},{"issue":"19","key":"pone.0343710.ref022","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1001\/archinte.168.19.2138","article-title":"Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis","volume":"168","author":"H Bahrami","year":"2008","journal-title":"Arch Intern Med"},{"issue":"4","key":"pone.0343710.ref023","doi-asserted-by":"crossref","first-page":"101528","DOI":"10.1016\/j.cpcardiol.2022.101528","article-title":"Racial disparity among the clinical outcomes post-myocardial infarction patients: a systematic review and meta-analysis","volume":"48","author":"V Jaiswal","year":"2023","journal-title":"Curr Probl Cardiol"},{"issue":"8","key":"pone.0343710.ref024","doi-asserted-by":"crossref","first-page":"101733","DOI":"10.1016\/j.cpcardiol.2023.101733","article-title":"Racial Disparities in Diagnostic Evaluation and Revascularization in Patients With Acute Myocardial Infarction-A 15-Year Longitudinal Study","volume":"48","author":"M Ashraf","year":"2023","journal-title":"Curr Probl Cardiol"},{"issue":"23","key":"pone.0343710.ref025","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.011964","article-title":"Contributions of geography and nongeographic factors to the white-black gap in hospital quality for coronary heart disease: a decomposition analysis","volume":"8","author":"I Popescu","year":"Dec 3 2019","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"pone.0343710.ref026","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s10865-008-9185-0","article-title":"Discrimination and racial disparities in health: evidence and needed research","volume":"32","author":"DR Williams","year":"2008","journal-title":"J Behav Med"},{"issue":"3","key":"pone.0343710.ref027","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/0146167218788553","article-title":"Identity denied: comparing american or white identity denial and psychological health outcomes among bicultural and biracial people","volume":"45","author":"AF Albuja","year":"2019","journal-title":"Pers Soc Psychol Bull"},{"issue":"1","key":"pone.0343710.ref028","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1540-4560.2008.01591.x","article-title":"To disclose or not to disclose biracial identity: the effect of biracial disclosure on perceiver evaluations and target responses","volume":"65","author":"DT Sanchez","year":"2009","journal-title":"Journal of Social Issues"},{"issue":"3","key":"pone.0343710.ref029","doi-asserted-by":"crossref","first-page":"317","DOI":"10.2217\/pmt-2018-0030","article-title":"Racial and ethnic differences in the experience and treatment of noncancer pain","volume":"9","author":"SM Meints","year":"2019","journal-title":"Pain Manag"},{"issue":"12","key":"pone.0343710.ref030","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1177\/1359105317694485","article-title":"Is disclosure a privilege? Race and disclosure patterns of hepatitis C","volume":"24","author":"AE Suarez","year":"2019","journal-title":"J Health Psychol"},{"issue":"6","key":"pone.0343710.ref031","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(23)00081-6","article-title":"Social determinants of health and premature death among adults in the USA from 1999 to 2018: a national cohort study","volume":"8","author":"JD Bundy","year":"2023","journal-title":"Lancet Public Health"},{"key":"pone.0343710.ref032","author":"Centers for Disease Control and Prevention","year":"2023"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0343710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T17:29:58Z","timestamp":1773077398000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0343710"}},"subtitle":[],"editor":[{"given":"Ronaldo","family":"Go","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0343710","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}