Disaggregating Office of Management and Budget Race/Ethnicity Data to Examine Racial Disparities in Late-Stage HIV Diagnosis, Hawaii, 2010-2022.

Objectives. To evaluate racial disparities when examining race at a more granular level than the broader 1997 Office of Management and Budget (OMB) categories. Methods. We examined HIV diagnoses in Hawaii during 2010 to 2022 by OMB race/ethnicity categories and an 18-category granular race/ethnicity variable that included the 10 most frequent Asian and Native Hawaiian/other Pacific Islander groups. We used multivariable logistic regression, adjusting for potential confounders. Results. During 2015 to 2022, using OMB race/ethnicity data and White people as the comparison group, we found that Asians were the only group at increased odds (adjusted odds ratio [AOR] = 3.69; 95% confidence interval [CI] = 1.86, 7.33) for late-stage HIV diagnosis. Using granular race/ethnicity and with White people as the comparison group, we found that Filipinos (AOR = 5.42; 95% CI = 2.27, 13.0), Asians with no ethnicity data (AOR = 8.21; 95% CI = 3.20, 21.06), and Pacific Islanders other than Native Hawaiians (AOR = 4.02; 95% CI = 1.10, 14.63) were at increased odds. Conclusions. Disaggregating racial/ethnicity data revealed important disparities in late-stage HIV diagnosis that would otherwise be obscured. Public Health Implications. Identification of racial disparities using granular data enables more targeted interventions to reduce late-stage HIV diagnoses and to improve health outcomes. (Am J Public Health. Published online ahead of print August 21, 2025:e1-e10. https://doi.org/10.2105/AJPH.2025.308192).