MOPDC0303 - Poster Discussion Session
Linkage, retention, ART use and viral suppression in four large cities in the United States
Presented by Nanette Benbow (United States).
N. Benbow1, S. Scheer2, A. Wohl3, K. Brady4, A. Gagner1, A. Hughes2, J. Tejero3, M. Eberhart4, V. Hu3, J. Sayles3, S. Townsell1
1Chicago Department of Public Health, Chicago, United States, 2San Francisco Department of Public Health, San Francisco, United States, 3Los Angeles County Department of Public Health, Los Angeles, United States, 4Philadelphia Department of Public Health, Philadelphia, United States
Background: Successful HIV treatment involves timely linkage to medical care, ongoing engagement in care, and adherence to effective HIV treatment regimens. Compared to national data, large urban areas may have significant variation in the level of successful engagement of PLHA in care and treatment. Identification of these differences can help reduce HIV disease transmission, morbidity and mortality
Methods: HIV case surveillance data from Chicago, Los Angeles County(LA), Philadelphia and San Francisco(SF) were used to compare linkage to care (≥1 CD4 or VL test within 3 months of diagnosis) among adults with a new HIV diagnosis in 2009. The proportion who have accessed care ( ≥1 CD4/VL test in 2009) was calculated for the estimated total HIV-infected adults, including those unaware and those reported with HIV infection, living in 2009. City estimates from the Medical Monitoring Project(MMP) were applied to the number of HIV infected individuals to calculate the percentage who were on ART, and among those on ART, the percentage virally suppressed (most recent VL≤200 copies/ml).
Results: The proportion of newly-diagnosed persons linked to and engaged in care was significantly higher in LA and SF compared to Chicago and Philadelphia(p< .01;Figure1). Among HIV-infected adults, 47% in LA and 50% in SF were on ART, compared with Chicago(26%), Philadelphia(34%), and the U.S. overall(36%). In addition, viral suppression was achieved among 46% of individuals in SF, 41% in LA, 27% in Philadelphia, and 22% in Chicago.
Across all cities, a higher percentage of Whites compared to Blacks who accessed care were on ART and were virally suppressed (range: 91%-94% vs. 83%-85%) and (88%-100% vs. 74%-84%) respectively.
Conclusions: Data from these cities highlight discrepancies in progress towards universal HIV care, and help identify effective regional interventions that promote access to care and treatment. Targeted programs and funding are needed to ensure care and eliminate racial/ethnic disparities.
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