Presentation on theme: "Introduction DCDOH supports HIV test and treat activities - increased number of HIV tests performed, emphasis on earlier linkage to care. Limited data."— Presentation transcript:
Introduction DCDOH supports HIV test and treat activities - increased number of HIV tests performed, emphasis on earlier linkage to care. Limited data about the impact of these efforts on viral suppression (VS). This analysis identified factors associated with achieving VS among a cohort of newly diagnosed HIV/AIDS cases. Methods Eligibility: HIV/AIDS cases diagnosed 2006-07, initial detectable VL followed by at least 1 additional VL test before 12/31/10. VS was defined as <400 copies/mL Performed bivariate analyses, multivariate LR and survival analyses to determine predictors of viral suppression. Results 2,412 cases diagnosed between 2006-2007; 988 met eligibility criteria. 648 of eligible cases achieved VS prior to 12/31/2010. Factors associated with achieving viral suppression among newly diagnosed HIV/AIDS cases in Washington, D.C Willis SJ, Castel AD, Griffin A, West T, Shaikh I, Pappas G
Continuous Care At least 2 VL tests per year vs. less than 2 VL tests per year AIDS vs. HIV, not AIDS Other race vs. White Hispanic vs. White Black vs. White Male vs. Female 40-49 vs. 13-29 50-59 vs. 13-29 30-39 vs. 13-29 Multivariate Logistic Regression† Results No difference in median VL at diagnosis (achieved VS: 22,583.5 copies/mL; no VS: 18,444.0 copies/mL, p=0.42) Individuals ≥50 yrs were 2.0 times as likely to achieve VS than 13-29 yr olds. AIDS diagnoses were 1.7 times as likely to achieve VS than individuals diagnosed with HIV, not AIDS. Individuals with 2+ VL tests/yr were 7.4 times as likely to achieve VS than individuals with <2 VL tests/yr. † Odds ratio adjusted for sex, race/ethnicity, age at diagnosis, diagnostic status, continuous care, and annual viral load test rate
Adjusted Cox Proportional Hazards Ratio (95% CI)† Sex Males vs. Females 1.08 (0.91, 1.28) Race/Ethnicity White vs. all other races 1.04 (0.82, 1.32) Age at HIV diagnosis ≥ 50 years vs. 13-49 years 1.49 (1.22, 1.82) Diagnostic status AIDS vs. HIV, not AIDS 1.45 (1.22, 1.74) Linkage to care ≤ 3 months vs. > 3 months 1.22 (1.01, 1.47) Continuous care Continuous vs. not continuous 1.40 (1.178, 1.66) Annual VL test rate At least 2 VL tests per year vs. less than 2 VL tests per year 3.21 (2.72, 3.78) Conclusions Engagement in care is directly associated with VS. Individuals that are immunosuppressed at diagnosis are more likely to achieve VS - motivated to seek care, adhere to treatment, provider behavior Individuals ≥50 years of age at diagnosis more likely to achieve VS. Programs that emphasize engagement in care are crucial to improving health of HIV-infected persons. Bolded values represent statistically significant values. †Cox Proportional Hazards Ratios were adjusted for sex, race/ethnicity, age at HIV diagnosis, diagnostic status, linkage to care, continuous care, and annual VL test rate.