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Substance Abuse and Mental Health Services Administration
Disparities in Engagement in Care and Viral Suppression among Persons with HIV
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Engagement across the spectrum of HIV care can improve health outcomes and prevent HIV transmission. We used HIV surveillance data to examine these outcomes. (Authors)
BACKGROUND:: Engagement across the spectrum of HIV care can improve health outcomes and prevent HIV transmission. We used HIV surveillance data to examine these outcomes.

METHODS:: San Francisco residents who were diagnosed with HIV between 2009 and 2010 were included. We measured the characteristics and proportion of persons linked to care within six months of diagnosis; retained in care for second and third visits; and virally suppressed within 12 months of diagnosis. 

RESULTS:: Of 862 persons included, 750 (87%) entered care within six months of diagnosis; of these, 72% had a second visit in the following 3-6 months; and of these, 80% had a third visit in the following 3-6 months. Viral suppression was achieved in 50% percent of the total population and in 76% of those retained for three visits. Lacking health insurance and homelessness was associated with not entering care (p<0.01). Persons with unknown insurance status were less likely to be retained for a second visit; those less than 30 years old were less likely to be retained for a third visit. Independent predictors of failed viral suppression included age <40 years, homelessness, unknown housing status, and having a single or two medical visits compared to three visits. 

CONCLUSION:: Socioeconomic resources and age, not race or gender, are associated with disparities in engagement in HIV care in San Francisco. (Authors)
Journal
2013
63
1
112-119
San Francisco
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