267656 High retention in care and durable viral suppression in an urban HIV housing services client population

Monday, October 29, 2012 : 12:45 PM - 1:00 PM

Arpi Terzian, PhD, MPH , HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, Queens, NY
Mary Irvine, DrPH , Bureau of HIV/AIDS Prevention & Control, The New York City Department of Health and Mental Hygiene, Queens, NY
John Rojas, MPA , Bureau of HIV/AIDS Prevention and Control, NYC DOHMH, Queens, NY
Laura McAllister, MPH , Bureau of HIV/AIDS Prevention and Control, NYC DOHMH, Queens, NY
Colin Shepard, MD , HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, Queens, NY
Background: The federal Housing Opportunities for Persons with AIDS (HOPWA) program addresses housing needs of low-income HIV-infected persons. The New York City (NYC) Department of Health and Mental Hygiene oversees NYC HOPWA and manages NYC surveillance data from the HIV Surveillance Registry (HSR). This analysis examined viral suppression and care retention in NYC HOPWA. Methods: HOPWA 2010 enrollees were matched with the HSR (N=2,535). Viral load (VL) and CD4 test events served as proxies for care. Based on the National HIV/AIDS Strategy (NHAS) indicator, retention was defined ≥2 tests per year ≥3 months apart. Durable suppression was defined as no VL >400 copies/mL, among clients with ≥2 VL ≥2 weeks apart in 2010. Results: 2,427 clients (96%) had a 2010 VL or CD4 test. The sample was largely male (62%), black or Hispanic (95%), and aged 40+ (71%). Approximately one-quarter of clients resided in each of Brooklyn, Manhattan and the Bronx. Reported transmission risks included MSM (27%), heterosexual (27%), unknown (23%), injection drug (22%), and perinatal (under 2%). Eight-six percent met the NHAS retention definition. Of 1,967 clients with ≥2 eligible VL results, 998 (51%) showed durable suppression. Durable suppression was less likely among Bronx clients, those under 30, and those with injection drug or perinatal transmission history. Conclusions: Half of NYC HOPWA clients achieved durable viral suppression. The groups less likely to succeed resembled those with suboptimal care engagement in the larger NYC population with HIV. Integrated analysis of surveillance and programmatic data offers a powerful tool for monitoring progress toward NHAS goals.

Learning Areas:
Administer health education strategies, interventions and programs
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. To describe HIV-infected New Yorkers enrolled in a federally funded housing program, Housing Opportunities for Persons with AIDS (HOPWA), addressing the housing needs of low-income HIV-infected persons in New York City. 2. To evaluate retention in HIV-related medical care and durable virologic suppression in HIV-infected New Yorkers enrolled in HOPWA. 3. To demonstrate the advantages of merging programmatic data with HIV surveillance data with expanded laboratory-reporting

Keywords: Access to Care, Housing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am primarily responsible for conducting the analysis and interpretation of results as Senior Analyst for the Care, Treatment, and Housing Program in the Bureau of HIV/AIDS at the NYC DOHMH.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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