Explaining Racial and Ethnic Disparities in Antiretroviral Therapy Adherence and Viral Suppression among U.S. Men Who Have Sex with Men

Details

• Alternative Title:
  AIDS
• Personal Author:
  PATEL, Deesha ; BEER, Linda ; YUAN, Xin ; TIE, Yunfeng ; BAUGHER, Amy R. ; JEFFRIES, William L. ; DAILEY, Andre ; HENNY, Kirk D.
• Corporate Authors:
  Medical Monitoring Project
• Description:
  Objective: ; To identify factors—including social determinants of health (SDOH)—that explain racial/ethnic disparities in antiretroviral therapy (ART) adherence and sustained viral suppression (SVS) among U.S. men who have sex with men (MSM) with HIV. ; Design: ; We used weighted data from 2017–2021 cycles of the Medical Monitoring Project. ; Methods: ; Among MSM taking ART, we calculated prevalence differences (PDs) with 95% confidence intervals (CIs) of ART adherence (100% ART adherence, past 30 days) and SVS (all viral loads in past 12 months <200 copies/mL or undetectable) for Black MSM (BMSM) and Hispanic/Latino MSM (HMSM) compared with White MSM (WMSM). Using forward stepwise selection, we calculated adjusted PDs with 95% CIs to examine if controlling for selected variables reduced PDs. ; Results: ; After adjusting for age, any unmet service need, federal poverty level (FPL), food insecurity, homelessness, time since HIV diagnosis, gap in health coverage, and education, the BMSM/WMSM PD for ART adherence reduced from −16.9 to −8.2 (51.5%). For SVS, the BMSM/WMSM PD reduced from −8.3 to −3.6 (56.6%) after adjusting for ART adherence, age, homelessness, food insecurity, gap in health coverage, FPL, any unmet service need, time since diagnosis, and ER visit(s). The HMSM/WMSM PD for ART adherence reduced from −9.3 to −2.9 (68.8%) after adjusting for age and FPL. The unadjusted HMSM/WMSM PD for SVS was not statistically significant. ; Conclusions: ; Adjusting for SDOH and other factors greatly reduced racial/ethnic disparities in ART adherence and SVS. Addressing these factors—particularly among BMSM—could substantially improve health equity among MSM with HIV.
• Subjects:
  • Humans
  • Male
  • Medication Adherence
  • HIV Infections
  • Homosexuality, Male
  • United States
  • Adult
  • Sustained Virologic Response
  • Middle Aged
  • Anti-Retroviral Agents
  More +
• Keywords:
  • HIV
  • antiretroviral therapy
  • viral suppression
  • MSM
  • disparities
• Source:
  AIDS. 38(7):1073-1080
• Pubmed ID:
  38418843
• Pubmed Central ID:
  PMC11063929
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  38
• Issue:
  7
• Download URL:
  https://stacks.cdc.gov/view/cdc/155127/cdc_155127_DS1.pdf
• File Type:
  [PDF - 381.37 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9b03b31e4b8eaa92c5841135363d43c4191bbf5c1f70f9cc76d93653aab2eb06