142nd APHA Annual Meeting and Exposition

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305597
Racial/Ethnic, Gender and Age Differences in Linkage, Retention, ART Use and Viral Load Suppression among HIV- Infected Persons in Los Angeles County

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Amy Wohl, MPH, PhD , Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Judith Tejero, MPH , Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Rhodri Dierst-Davies, MPH , Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Background: There are limited data on disparities in the HIV care continuum (linkage to and retention in care, antiretroviral treatment (ART) use and viral load suppression) for high morbidity areas. This analysis describes the HIV care continuum for diagnosed persons living with HIV in Los Angeles County (LAC), California in 2009 overall and by race/ethnicity, gender, and age.  

Methods: We used LAC’s 2009 HIV surveillance and Medical Monitoring Project data.

Results: Among new diagnoses, 77% were linked to care within three months of diagnosis.  Among all persons living with HIV, 56% were retained in care, 50% were on ART and 42% were virally suppressed.  African Americans (Risk Ratio (RR)=0.90, CI (0.89, 0.91)), Latinos (RR=0.94, CI (0.93, 0.95)), other racial/ethnic groups (RR=0.95, CI (0.93, 0.97)), females (RR=0.94, CI (0.92, 0.96)), younger persons age 18-29 years (RR=0.87, CI (0.85, 0.89)) and persons age 30-49 years (RR=0.97, CI (0.96, 0.98)) were less likely to have linked to care compared to whites, males, and persons age 50 and older respectively.  Racial/ethnic and age disparities persist in retention in care.  Non-whites (RR=0.92, CI (0.85, 0.99)) were less likely to be on ART compared to whites.  Younger persons age 18-34 years (RR=0.75, CI (0.59, 0.95)) were less likely to be virally suppressed compared to persons age 35 and older. 

Conclusions: These data highlight disparities in LAC’s HIV care continuum and can be used to target programs to improve linkage to and retention in care to support ART use, improved viral load suppression and reduced HIV transmission.

Learning Areas:

Chronic disease management and prevention
Epidemiology

Learning Objectives:
Describe the HIV care continuum for diagnosed persons living in Los Angeles County; Identify disparities in the HIV care continuum by race/ethnicity, gender and age.

Keyword(s): Health Disparities/Inequities, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have multiple years of experience in the fields of HIV research and program evaluation. I have also performed program management for multiple federally funded research projects related to HIV prevention and health care delivery.
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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