MOPDC0304 - Poster Discussion Abstract
Factors associated with achieving viral suppression among newly diagnosed HIV/AIDS cases in the Washington, D.C.
Presented by Sarah Willis (United States).
S. Willis1, A. Castel1, A. Griffin2, T. West2, I. Shaikh2, G. Pappas2
1The George Washington University, Department of Epidemiology and Biostatistics, Washington, United States, 2District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD and TB Administration, Washington, United States
Background: The District of Columbia Department of Health (DCDOH) has supported HIV test and treat activities by increasing the number of tests performed and emphasizing earlier linkage to care. Data on the impact of these efforts on viral suppression (VS) and continuity of care are limited. This analysis sought to identify factors associated with VS among newly diagnosed HIV-infected persons.
Methods: HIV-infected persons diagnosed from 2006-2007 were identified in the DCDOH HIV/AIDS surveillance database. Cases with an initial detectable viral load (VL) followed by at least one additional VL test prior to 12/31/10 were included. VS was defined as VL < 400 copies/mL. Bivariate analyses and multivariate logistic regression were performed to detect differences between those who were VS and those who were not. Among VS cases, Cox proportional hazards ratios and Kaplan-Meier survival analysis were conducted to identify predictors of VS.
Results: Of 988 newly diagnosed cases, 66% achieved VS prior to 12/31/2010. VS cases were significantly more likely to be ≥50 years of age at diagnosis (19% vs. 11%, p=0.008) and in continuous care, defined as 2 visits 3 months apart within 12 months (32% vs. 22%, p=0.002). Cases concurrently diagnosed with AIDS were also more likely to achieve VS (73% vs. 62%, p< .0001). Multivariate logistic regression revealed that MSM (aOR 1.62, 95% CI 1.1,2.4) were significantly more likely to achieve VS than heterosexuals. Among those achieving VS, survival analysis found that those ≥50 years of age at diagnosis (aHR 1.44 95% CI 1.2,1.8), those linked to care within 3 months (aHR 1.35 95%CI 1.1,1.6), and those in continuous care (aHR 1.73 95% CI 1.5,2.1) were significantly more likely to achieve VS.
Conclusions: These findings demonstrate the importance of earlier linkage and continuity of care in achieving viral suppression and highlight the need for more navigation programs targeted to HIV-infected persons.
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