Racial, gender, and psychosocial disparities in viral suppression trends among people receiving coordinated HIV care in Los Angeles County

Author:

Li Michael J.12,Chau Brendon23,Garland Wendy H.4,Oksuzyan Sona4,Weiss Robert E.13,Takada Sae5,Kao Uyen12,Lee Sung-Jae16,Shoptaw Steven J.12

Affiliation:

1. Center for HIV Identification, Prevention and Treatment Services

2. Department of Family Medicine

3. Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles

4. Division of HIV and STD Programs, Los Angeles County Department of Public Health

5. Division of General Internal Medicine and Health Services Research

6. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA.

Abstract

Objective: To longitudinally evaluate differences in HIV viral suppression (<200 copies/ml) by intersections of race/ethnicity, gender, and psychosocial issues in people with HIV in the Los Angeles County Medical Care Coordination Program. Design: We analyzed 74 649 viral load measurements over 10 184 people with HIV enrolled in the Medical Care Coordination Program between January 1, 2013 and March 1, 2020. Methods: We fit Bayesian logistic hierarchical random effects models to test interactions between gender, race/ethnicity, and a psychosocial acuity score on viral suppression over time from 1 year prior to program enrollment to 24 months after enrollment. Results: The probability of viral suppression declined prior to enrollment, then increased and stabilized by 6 months after enrollment. Black/African American patients with low and moderate psychosocial acuity scores did not achieve the same increase in percentage of viral suppression as those in other racial/ethnic groups. Transgender women with high psychosocial acuity scores took longer (about 1 year) to achieve the same percentage of viral suppression as clients of other gender identities. Conclusions: Some racial/ethnic and gender disparities in viral suppression persisted after enrollment in the Los Angeles County Medical Care Coordination Program while accounting for psychosocial acuity score, which may be explained by factors not assessed in the program.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Infectious Diseases,Immunology,Immunology and Allergy

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