Disparities in Engagement in Care and Viral Suppression among Persons with HIV
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)
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