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- Title
Linkage to HIV Medical Care and Social Determinants of Health Among Adults With Diagnosed HIV Infection in 41 States and the District of Columbia, 2017.
- Authors
Gillot, Myrline; Gant, Zanetta; Hu, Xiaohong; Satcher Johnson, Anna
- Abstract
Objectives: To reduce the number of new HIV infections and improve HIV health care outcomes, the social conditions in which people live and work should be assessed. The objective of this study was to describe linkage to HIV medical care by selected demographic characteristics and social determinants of health (SDH) among US adults with HIV at the county level. Methods: We used National HIV Surveillance System data from 42 US jurisdictions and data from the American Community Survey to describe differences in linkage to HIV medical care among adults aged ≥18 with HIV infection diagnosed in 2017. We categorized SDH variables into higher or lower levels of poverty (where <13% or ≥13% of the population lived below the federal poverty level), education (where <13% or ≥13% of the population had <high school diploma), and health insurance coverage (where <12% or ≥12% of the population lacked health insurance). We calculated prevalence ratios (PRs) and 95% CIs. Results: Of 33 204 adults with HIV infection diagnosed in 2017, 78.4% were linked to HIV medical care ≤1 month after diagnosis. Overall, rates of linkage to care were significantly lower among men and women living in counties with higher versus lower poverty (PR = 0.96; 95% CI, 0.94-0.97), with lower versus higher health insurance coverage (PR = 0.93; 95% CI, 0.92-0.94), and with lower versus higher education levels (PR = 0.97; 95% CI, 0.96-0.98). Conclusions: Increasing health insurance coverage and addressing economic and educational disparities would likely lead to better HIV care outcomes in these areas.
- Subjects
WASHINGTON (D.C.); HIV infection epidemiology; DIAGNOSIS of HIV infections; EVALUATION of medical care; HEALTH services accessibility; SOCIAL determinants of health; CONFIDENCE intervals; SURVEYS; SOCIOECONOMIC factors; HEALTH insurance; DISEASE prevalence; DESCRIPTIVE statistics; SOCIODEMOGRAPHIC factors; POVERTY; HEALTH equity; INSURANCE; ADULTS
- Publication
Public Health Reports, 2022, Vol 137, Issue 5, p888
- ISSN
0033-3549
- Publication type
Article
- DOI
10.1177/00333549211029971