300295
Association of neighborhood-level socioeconomic status (SES) with time from HIV diagnosis to viral suppression among newly diagnosed New Yorkers, 2006–2010
HIV viral suppression decreases the probability of onward transmission and is a goal of the National HIV/AIDS Strategy. Population-based analyses of viral suppression have not examined the influence of neighborhood-level SES.
Methods
Demographics (age, sex, race, area of birth), transmission risk, diagnosis date, viral loads, CD4 counts, and address of residence at diagnosis from the New York City HIV surveillance registry were linked to census tract-level SES measures for poverty (percent of residents with incomes under federal poverty threshold), unemployment (among residents 16+), and education (percent of residents 25+ graduated from high school) from 2011 American Community Survey 5-year estimates. Among persons newly diagnosed with HIV in 2006–2010, 13+ years old at diagnosis, who had tract-level SES variables (84% of total cases 13+), we calculated days from HIV diagnosis to first suppression (≤400 copies of RNA/mL plasma), with follow-up through 12/31/2012. Multilevel Cox proportional hazards regression estimated the association of tract-level SES measures with time to suppression, controlling for individual demographics, risk, diagnosis year, and treatment eligibility.
Results
Out of 14,794 New Yorkers newly diagnosed with HIV in 2006–2010, 73.4% achieved viral suppression by 12/31/2012 (median days to suppression: 228). Neighborhood poverty, unemployment and education levels were not associated with time to suppression even in adjusted models: HR(95%CI)=1.02(0.95-1.09; ≥30% vs. <10% in poverty), 1.00(0.92-1.08; <60% vs. ≥90% graduated high school) and 1.01(0.93-1.09; ≥15% vs. <5% unemployed), respectively.
Conclusions
Among New Yorkers newly diagnosed with HIV, neighborhood-level SES does not influence the time from diagnosis to viral suppression.
Learning Areas:
EpidemiologySocial and behavioral sciences
Learning Objectives:
Describe the association of neighborhood-level socioeconomic characteristics with HIV-related viral suppression
Keyword(s): HIV/AIDS, Poverty
Qualified on the content I am responsible for because: I have a master's degree in public health and have for ten years analyzed HIV surveillance data for NYC as an epidemiologist with the NYC health department.
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.