Abstract
Sociodemographic, clinical, and housing factors associated with a lack of viral suppression among HIV-positive clients of a federally funded housing program, New York City, 2014
Christopher Beattie, MPH1, Ellen Wiewel, DrPH, MHS1, Joanne Hsu, MPH1, Yaoyu Zhong, MS1, Xiomara Farquhar, MPA1, Eleonora Jimenez-Levi, MS1, Sarah Braunstein, PhD MPH1 and John Rojas, MPA2
(1)New York City Department of Health and Mental Hygiene, Long Island City, NY, (2)New York City Department of Health and Mental Hygiene, Queens, NY
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
The Housing Opportunities for Persons with AIDS (HOPWA) program provides housing-related services to low-income persons living with HIV (PLWH) in New York City (NYC). Compared with NYC PLWH not in HOPWA, HOPWA clients have higher rates of retention in HIV-related medical care, but not higher rates of HIV viral suppression. To better understand this discrepancy, we examined sociodemographic and clinical factors associated with a lack of viral suppression ("non-suppression") among in-care NYC HOPWA clients.
Clients receiving at least one HOPWA service in 2014 were matched to the NYC HIV surveillance registry to obtain laboratory test values for the outcome of interest, defined as VL > 200 copies/mL at last care visit in 2014. Demographic and socioeconomic variables were obtained from quarterly assessments conducted by agencies providing HOPWA services. Multivariable logistic regression was conducted to determine variables associated with non-suppression.
Of 1,665 HOPWA clients in care, 353 (21.2%) were unsuppressed. Factors associated with non-suppression included younger age (18-29 vs. ≥55, adjusted odds ratio [AOR]=1.88; 95% confidence interval [CI]=1.24-2.83), recent substance use (three months) (AOR[95% CI]=1.60[1.23-2.07]), and unstable housing (vs. receiving rental assistance, AOR[95% CI]=2.37[1.47-3.84]). Neighborhood-level poverty and current treatment for substance use were not associated with non-suppression.
In-care HOPWA clients who were young, substance users, or unstably housed were more likely to be unsuppressed and may benefit from tailored interventions to increase suppression. In an equity-focused component of ending the HIV epidemic in New York State, investigations are underway to determine how HOPWA programs can help these clients achieve suppression.
Conduct evaluation related to programs, research, and other areas of practice Epidemiology Program planning Public health or related public policy