Public health researcher at UH Hilo addresses health disparities in Hawai‘i Island HIV/AIDS community

Native Hawaiians and Pacific Islanders are in the top three ethnicities with the highest rates of HIV diagnoses in the country. Misty Pacheco is researching health disparities experienced by Hawai‘i Island HIV/AIDS patients in comparison to those living elsewhere.

By Alyssa Mathews.

Misty Pacheco
Misty Pacheco

Although it may come as a surprise as it is a relatively small population, Native Hawaiians and Pacific Islanders are in the top three ethnicities with the highest rates of HIV diagnoses in the country.

“Native Hawaiians and Pacific Islanders, behind African-Americans, behind Hispanics, are the third-highest rate for HIV diagnoses, even though we are such a small population,” says Misty Pacheco, associate professor of kinesiology and exercise science at the University of Hawai‘i at Hilo. She specializes in public health and teaches in the health promotion track at UH Hilo.

Practical research on health disparities in local HIV/AIDS community

In response to the alarming rates of HIV and AIDS diagnoses among the local population, Pacheco is working on a local HIV research project titled, “Disparities in primary care and HIV-related support service needs among Native Hawaiians and other Pacific Islanders living with HIV in Hawai‘i.”

The research primarily looks at the disparities or differences in the experiences that HIV/AIDS-diagnosed Native Hawaiians and Pacific Islanders living in Hawai‘i have in comparison to those living elsewhere in the country.

“I am specifically looking at the satisfaction with the care they receive, and viral suppression, which basically means they have control of their disease, they are on [effective] medication and regularly seeing a provider,” Pacheco explains. “I’m looking to see, with those two outcomes, does it differ with Native Hawaiians and Pacific Islanders [from] all other race groups?”

She notes the local community does experience health disparities in chronic diseases. “Figuring out how we are going address these disparities is very important,” says Pacheco.

The goal of her research is to find a way to prevent these disparities from happening. Addressing the problem in a way that best appeals to the local community is key.

“If we do see [disparity]—for example, less Native Hawaiians or Pacific Islanders are virally suppressed or less satisfied with the care they receive—then we can look into what’s causing that,” says Pacheco.

Further complicating things, local cases are often more serious because patients are being diagnosed in later stages of the diseases, which makes the situation even more dire in Hawai‘i.

“When we look at data locally, we see that Native Hawaiians and Pacific Islanders are getting diagnosed much later [in the stages of HIV/AIDS],” says Pacheco. “[Patients] are coming in with late-stage diagnoses, some already with an AIDS diagnosis, so getting them the care they need and the medication is important, because their cases are already way more severe.”

As a result of late diagnosis, the rates of hospital admission of HIV/AIDS patients are higher in the state.

“We also have higher rates of hospital admission, which makes sense if they are coming in with late-stage diagnoses,” Pacheco says. “So there is some disparities that do exist, but there is not much data and research out there. Hopefully the study that I’m doing will collect enough data for us to understand why this is happening.”

Along with the quantitative data from surveys, Pacheco also interviews Native Hawaiians and Pacific Islanders living with HIV/AIDs. “With mixed methods, both qualitative and quantitative data, I have good baseline data to go off of to develop an intervention,” says Pacheco, “I’ll be getting a more intimate understanding of what their care and service needs are.” Through a more thorough and personalized understanding of the needs of diagnosed local patients, local health services can develop the best-suited intervention and support system for them.

“The long term goal is to develop an intervention [protocol],” Pacheco explains. “Hopefully, through the interviews and analyzing the secondary data, we can identify what the needs are, what the priorities are, and develop a culturally responsive intervention to address those needs.”

UH Hilo students have also contributed to HIV/AIDS research through gathering background information. “I usually do recruit students to do things that I’ve introduced in my classes [such as] where they can gather evidence-based data,” says Pacheco.

Through this community-based research, Pacheco hopes to further develop programs and interventions for the Native Hawaiian and Pacific Islander HIV/AIDS population in a culturally effective way.

“If it comes from the community, and they identify what their needs and priority and the best way in addressing them, it will be more accepted by them. Whatever intervention or program that comes out of that, will be more sustainable,” Pacheco said. “Empowering the community and building that capacity through community-based research projects is the greatest benefit. Not only do they learn but they take ownership of what’s in their community.”

Developing program

Pacheco is working with a Hawai‘i Island non-profit, the Hawai‘i Rise Foundation, a 501(c)(3) that helps low-income families, children and the elderly by providing educational and cultural services, programs and support.

“I am involved in evaluating and designing a program specifically providing services and workshops, focusing on the social determinants of health,” Pacheco says.

The program is working toward encouraging local youth in completing their education in order to create a more aware and healthy local population throughout Hawai‘i state. Pacheco says this kind of outreach will hopefully have a positive impact on informing and unifying the community.

Learn about Pacheco’s other research.

This post was updated on Sept. 28, 2018 to remove information about privacy issues—that information was from a survey on a different topic. The link to a new post on Pacheco’s other research was added on Jan. 25, 2019.


Story by Alyssa Mathews, a freshman at UH Hilo. She graduated from Waiakea High School and is a UH Hilo Chancellor’s Scholar.