METHODS: Data were obtained from the Medical Monitoring Project (MMP), an expanded HIV surveillance project conducted by the NYS Department of Health in collaboration with CDC and Health Resources and Services Administration. Eligible participants received HIV medical care in at least one of the sample years 2009-2014; this was used to define the in HIV care population. Participants (n=1,041) were matched to the whole state HIV surveillance registry which includes ongoing reports of all values of HIV viral load test results (VL). Viral suppression (VS) was assessed for the MMP sample year. Consistent viral suppression is defined as having only VL<200 copies per mL in the MMP year. Logistic regression was performed determine the likelihood of VS by demographics and other key measures.
RESULTS: In this population of in-care PLWDHI, VS significantly varied by race, age, and survival status. Hispanics, non-Hispanic blacks, and multi-racial identifying persons were less likely to be consistently virally suppressed compared to non-Hispanic whites (OR 1.5, p=0.0295; OR 1.9 p<0.0005; OR 1.7 p=0.0076). Older persons (ages 55-64 and 65+) were significantly more likely to be consistently virally suppressed compared to 35-44 year olds (OR 0.6 p=0.048; OR 0.186 p=0.0007). There were no significant differences in consistent VS for the younger age groups compared to the 35-44 year olds. Persons deceased within one year of the MMP interview were less likely to be virally suppressed compared to participants who survived (OR 3.8, p=0.0006). There were not significant differences in VS by sex at birth, transmission risk, HIV disease progression, or diagnosis pre/post HAART availability.
CONCLUSIONS: Despite the in-care status of this population, we documented significant disparities in VS by race, age, and survival status. People of color were least likely to achieve sustained VS; whereas older PLWDHI were more likely than younger participants to achieve VS. These findings illustrate the complex nature of achieving sustained VS and point to the need for enhanced retention and medication adherence services even among populations of PLDWHI receiving routine HIV care.