Sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression in the Miami-Dade County Ryan White Program, 2017

ABSTRACT

This exploratory study examined sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression (SVS). The study population included 6,489 Miami-Dade Ryan White Program (RWP) clients receiving services during 2017; administrative data was analyzed. SVS was defined as having all viral load tests during 2017 below 200 copies/ml. Multilevel logistic regression models accounted for clustering by medical case management site. Models were stratified by sex. Overall, a higher proportion of females did not achieve SVS (23.5%) than males (18.1%). For females (n = 1,503), having acquired HIV perinatally and not having a partner oradult household member were associated with not achieving SVS. For males (n = 4,986), lacking access to food, Black or Haitian race/ethnicity, problematic substance use, and unknown physician were associated with not achieving SVS. For both sexes, younger age, lower household income, ever having an AIDS diagnosis, feeling depressed or anxious, and experiencing homelessness were associated with not achieving SVS. Elements of the transition from adolescent to adult HIV care that may differentially impact female clients and factors associated with disclosure should be explored further. Male clients may require additional support for food security. Improving culturally specific care for Haitian and non-Hispanic Black male clients should also be explored.

KEYWORDS:

• sustained viral suppression
• sex differences
• Ryan White Program

Acknowledgements:

The authors wish to gratefully acknowledge Carla Valle-Schwenk, Ryan White Program Administrator, and the entire Ryan White Part A Program in the Miami-Dade County Office of Management and Budget, for their active assistance, cooperation and facilitation in the implementation of this study. The authors also gratefully acknowledge partial support by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Numbers U54MD012393 (Florida International University Research Center in Minority Institutions) and K01MD013770. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported in part by National Institute on Minority Health & Health Disparities (NIMHD) Awards R01MD013563, R01MD012421, 3R01MD013563-02S1, K01MD013770, F31MD015234, and U54MD012393. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.