Risk profiles among Black communities in an HIV epicenter: a latent class approach

Black residents of Miami-Dade County experience among the worst HIV outcomes in the United States. Research suggests tailoring strategies to reflect population-specific patterns of risk may improve intervention impact. Yet HIV interventions often prioritize the factors of greatest risk regardless of their prevalence within a given population. To better inform the reach and effectiveness of a community-based HIV intervention for diverse Black communities, we used latent class analysis (LCA) to empirically identify behavioral subgroups within a cohort of over 1,000 predominantly Black South Florida residents. From December 2016 to April 2019, a community health worker–led HIV prevention program collected demographic and HIV risk data. LCA was performed using 12 risk indicators, resulting in five classes: Minimal Engagement (31%), Substance Use (4%), Condomless Engagement (43%), Impaired–Condomless Engagement (18%), and Syndemic Risk (4%). Findings support the value of LCA for designing efficient, context-aware, and resource-conscience HIV interventions.