Individual and neighborhood predictors of retention in care and viral suppression among Florida youth (aged 13-24) living with HIV in 2015

Int J STD AIDS. 2019 Oct;30(11):1095-1104. doi: 10.1177/0956462419857302. Epub 2019 Sep 24.

Abstract

Youth aged 13‒24, are less likely to be retained in HIV care and be virally suppressed than older age groups. This study aimed to assess predictors of retention in HIV care and viral suppression among a population-based cohort of youth (N=2,872) diagnosed with HIV between 1993 and 2014 in Florida. We used generalized estimating equations (GEE) to estimate prevalence ratios (PRs). Retention in care was defined as evidence of engagement in care (at least one laboratory test, physician visit, or antiretroviral therapy prescription refill), two or more times, at least three months apart during 2015. Viral suppression was defined as having evidence of a viral load <200 copies/mL among those in care during 2015. Among the 2,872 youth, 65.4% were retained in care, and among those in care, 65.0% were virally suppressed. Older youth (18‒24 years-old) and non-Hispanic Blacks (NHBs) were less likely to be retained in care; whereas those with male-to-male sexual HIV transmission, perinatal HIV transmission, living in low socioeconomic neighborhoods, and those diagnosed with AIDS before 2016 were more likely be retained in care. Those diagnosed with AIDS before 2016 and NHBs were less likely to be virally suppressed; whereas those with male-to-male sexual HIV transmission and foreign-born persons were more likely to be virally suppressed. Results suggest the need for targeted retention and viral suppression interventions for NHB youth, and older youth (18‒24 years-age).

Keywords: HIV; individual; neighborhood; retention; viral suppression; youth.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anti-HIV Agents / therapeutic use*
  • Cohort Studies
  • Female
  • Florida
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • Humans
  • Male
  • Prevalence
  • Residence Characteristics*
  • Retention in Care / statistics & numerical data*
  • Retrospective Studies
  • Rural Population / statistics & numerical data*
  • Social Determinants of Health
  • Urban Population / statistics & numerical data*
  • Viral Load / drug effects
  • Young Adult

Substances

  • Anti-HIV Agents