Introduction: Timely linkage-to-care and commencement of antiretroviral therapy (ART) remain vital to attaining undetectable viral loads (VL). As part of ongoing SC Big Data analytics project, we examined associations between neighborhood disadvantages and percent person-time with detectable VL for people living with HIV (PLWH) in South Carolina.

Methods: We examined PLWH diagnosed between 1/1/2014 – 12/31/2017, with two or more VL tests 6 months apart (n=2,076). Proportion of time spent living with detectable VL after linkage to care was determined. Neighborhood disadvantage was assessed using the area deprivation index (ADI). A generalized linear model was fit to generate parameter estimates for time spent with detectable VL.

Results: The mean age of the study population is 34.8 years. Most individuals were Black (69.4%), male (79.7%), MSM (57.8%), urban residents (75.1%) and living in the most disadvantaged neighborhoods (37.9%). Almost half of PLWH (49.5%) lived with detectable VL for some time (median days =518). Multivariable analyses showed age, race, transmission risks and proportion of time spent in care as important predictors significantly associated with time spent living with detectable VL in South Carolina. Young adults and injection drug users had the highest proportion for time living with detectable VL. PLWH living in the most socioeconomically disadvantaged neighborhoods had the most time (731 days) living with detectable VL.

Conclusions: PLWH living in disadvantaged neighborhoods had more time living with detectable VL. Targeted programs based on these characteristics are needed to improve VL suppression, reduce new transmissions and decrease disparities in HIV outcomes.