Mapping the Association Between HIV Viral Load Suppression and Accessibility to Expert HIV Medical Care and Poverty Rates by Census Tract of Residence in Wisconsin (CSTE Health Disparities Pilot Project)

BACKGROUND:  Prolonged virologic suppression of HIV is associated with both improved health status in HIV-infected individuals and reduced risk of transmission.

METHODS: The study will include the census tract of last known residence for adult cases of HIV from the Wisconsin Enhanced HIV/AIDS Reporting System (eHARS). Cases will be included if they were living with HIV in Wisconsin, were 18 years of age, and were alive, during any portion of  2012. Cases will be assessed for HIV viral load suppression based on legislatively mandated laboratory-based reports of HIV viral load. Aggregate viral load data will be presented in quartiles, showing the relationship to accessibility to expert HIV medical care and to poverty rates of census tract of residence. 

RESULTS: Analysis will be conducted in early 2013. We anticipate that in rural areas of Wisconsin, greater virologic suppression will be associated with closer proximity to expert HIV care. However in Milwaukee, where the density of HIV care providers is greater, virologic suppression may be more closely associated with the poverty status of the individual’s community of residence.   

CONCLUSIONS: Findings from this investigation will be used to identify medically underserved communities within Wisconsin and show how the status of an individual’s infection with HIV relates to community socio-demographic characteristics and proximity to expert treatment.