Jurisdiction Level Differences in HIV Diagnosis, Retention in Care, and Viral Suppression in the United States

Gray, Kristen Mahle; Cohen, Stacy M.; Hu, Xiaohong; Li, Jianmin; Mermin, Jonathan; Hall, H. Irene

doi:10.1097/qai.0000000000000028

Cited by 36 publications

(62 citation statements)

References 10 publications

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“…Further, those with a high school degree/GED or less had lower levels of interest and participating in masturbation (P < .05). Males with CD4 counts <200 cells/mm 3 had lower overall sexual function, interest, desired, and arousal compared to those with CD4 counts 200 cells/mm 3 (P < .05). Males with unsuppressed viral loads also appeared to have lower sexual function related to interest, desire, and arousal in comparison to those with suppressed viral loads (P < .05).…”

Section: Resultsmentioning

confidence: 95%

“…HIV viral loads were dichotomized (<400 copies/mL and >400 copies/mL) as was the standard test results at the time of data collection. CD4 counts were dichotomized as well (<200 cells/mm 3 and >200 cells/mm 3 ). Descriptive analyses were conducted to define the overall sample.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Identifying factors that interrupt HIV medical care and medication adherence is key in improving health outcomes across the continuum of care. 3 Addressing sexual health needs is an integral component of comprehensive HIV care and may serve as a barrier to adherence to care as is considered a basic need among populations who are infected. 4,5 Sexual function is likely to be minimally addressed in HIV care and is a fundamental component of physical and mental health.…”

Section: Introductionmentioning

confidence: 99%

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Examining Sexual Function Among Individuals With HIV in a Midwestern US Urban Outpatient Clinic Setting

Shacham

López

Souza

et al. 2017

J Int Assoc Provid AIDS Care

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The role of sexual function and its impact on HIV management have been inadequately evaluated. A cross-sectional study in 2009 of 202 patients with HIV were recruited to examine sexual function and psychosocial/HIV management factors. Analyses assessed the relationship between sexual function, sociodemographic factors, biomedical markers, and depressive symptomology. The M-Estimator compared differences in the means of the HIV, cancer survivors, and the normative cohorts. More than 75% were on combination antiretroviral therapy, of which 70% had suppressed HIV viral loads. Patients with unsuppressed HIV viral loads reported lower rates of arousal. Better overall health was associated with higher rates of overall sexual function, arousal, and interest. Compared to the normative and cancer survivor cohorts, mean sexual function was significantly lower in the HIVinfected cohort in all subscales, except for masturbation. These findings suggest lower sexual function impacts individuals with HIV in ways related to negative biomedical and psychosocial factors.

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Section: Resultsmentioning

confidence: 95%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Examining Sexual Function Among Individuals With HIV in a Midwestern US Urban Outpatient Clinic Setting

Shacham

López

Souza

et al. 2017

J Int Assoc Provid AIDS Care

View full text Add to dashboard Cite

show abstract

“…25 It has also been demonstrated that engagement and retention in care vary widely by state and location in the United States, underscoring the need to evaluate geographic and localized gaps in the continuum of care. 26 Prior studies have shown that lack of continuous engagement in care is associated with noninitiation of ARV. 8,27 In contrast, the number of visits in the past year was not significantly associated with ARV prescription in our study.…”

Section: Discussionmentioning

confidence: 99%

Engagement in Outpatient Care for Persons Living with HIV in the United States

Oramasionwu

Bailey²,

Johnson³

et al. 2015

AIDS Research and Human Retroviruses

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Prior studies that have assessed engagement within the various stages of care for persons living with HIV (PLWH) studied patients receiving care in HIV medical care facilities. These data are not representative of care received throughout the United States, as not all PLWH receive care in HIV clinics. This study evaluated engagement in outpatient care and healthcare utilization for PLWH, beyond facilities that specialize in HIV. Cross-sectional data were from the 2009-2010 National Hospital Ambulatory Medical Care Survey. Levels of care included receiving any care, receiving HIV-related care, established in care, engaged in care, and prescribed antiretroviral therapy (ARV). Factors associated with ARV prescription were determined by logistic regression. We analyzed data for *2.6 million outpatient clinic visits for PLWH. Of these, 90% were receiving HIV-related care, 86% were established in care, 75% were engaged in care, and 65% were prescribed ARV. In stratified analysis, the proportion of PWLH who were engaged in care varied by race/ethnicity ( p < 0.001) and ARV prescription varied significantly across the three age groups ( p = 0.004). Clinic visits within the past year did not differ for those prescribed ARV vs. not prescribed ARV [median, IQR = 3.3 visits (1.8-5.6) vs. 3.6 visits (1.3-5.9); p = 0.7]. Seeing a physician was associated with ARV prescription (OR = 0.27, 95% CI = 0.15-0.51), whereas routine engagement in care was not associated with ARV prescription (OR = 0.99, 95% CI = 0.96-1.03). Given that non-ARV-treated PLWH utilized outpatient care services at rates similar to ARV-treated PLWH, these routine clinic visits are missed opportunities for increasing ARV prescription in untreated patients.

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“…[1][2][3][4][5][6] The continued and increasing need for high-quality, usable surveillance data was underscored by the release of the 2010 National HIV/AIDS Strategy (NHAS), which calls for a coordinated national response to HIV in the United States. 7 To maximize the ability to monitor trends in HIV in the U.S. and progress toward meeting prevention goals, the Centers for Disease Control and Prevention (CDC) has developed a comprehensive National HIV Surveillance System (NHSS) that guides data collection and reporting.…”

mentioning

confidence: 99%

The Status of the National HIV Surveillance System, United States, 2013

et al. 2014

Self Cite

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The burden of HIV disease in the United States is monitored by using a comprehensive surveillance system. Data from this system are used at the federal, state, and local levels to plan, implement, and evaluate public health policies and programs. Implementation of HIV reporting has differed by area, and for the first time in early 2013, estimated data on diagnosed HIV infection were available from all 50 states, the District of Columbia, and six U.S. dependent areas. The newly available data for the entire U.S. as well as several other key changes to the surveillance system support the need to provide an updated summary of the status of the National HIV Surveillance System.

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Jurisdiction Level Differences in HIV Diagnosis, Retention in Care, and Viral Suppression in the United States

Cited by 36 publications

References 10 publications

Examining Sexual Function Among Individuals With HIV in a Midwestern US Urban Outpatient Clinic Setting

Examining Sexual Function Among Individuals With HIV in a Midwestern US Urban Outpatient Clinic Setting

Engagement in Outpatient Care for Persons Living with HIV in the United States

The Status of the National HIV Surveillance System, United States, 2013

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