Rahel Dawit1, Mary Jo Trepka1,2, Dustin T Duncan3, Semiu O Gbadamosi1, Tan Li4, Stephen F Pires5, Robert A Ladner6, Diana M Sheehan7,8,9. 1. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Miami, FL, 33199, USA. 2. Research Center in Minority Institutions (RCMI), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. 3. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. 4. Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. 5. Department of Criminology & Criminal Justice, Steven J. Green School of International & Public Affairs, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. 6. Behavioral Science Research Corporation, 2121 Ponce de Leon Blvd #240, Coral Gables, FL, 33134, USA. 7. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Miami, FL, 33199, USA. dsheehan@fiu.edu. 8. Research Center in Minority Institutions (RCMI), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. dsheehan@fiu.edu. 9. Center for Research On U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA. dsheehan@fiu.edu.
Abstract
BACKGROUND: Identifying geographic locations most affected by the HIV epidemic is essential to addressing disparities that impact people living with HIV. This study sought to identify individual and neighborhood-level factors that are associated with residing in geographic hotspots of poor sustained HIV viral suppression. METHODS: Using data from the Miami-Dade County Ryan White HIV/AIDS program, spatial autocorrelation of poor sustained viral suppression (at least 1 laboratory test ≥ 200 copies/ml in 2017) was investigated using Global Moran's I followed by Local Moran's I and Getis Ord Gi* statistics by ZIP code tabulation areas (ZCTAs). Subsequently, multivariable logistic regression analysis was conducted to identify factors associated with residing in geographic hotspots of poor sustained viral suppression. RESULTS: Several ZCTAs in the northern part of the county, accounting for 1/3 of the Ryan White program clients, had significantly higher clustering of poor sustained viral suppression. Client-level sociodemographic characteristics such as race/ethnicity, age, and poverty, and neighborhood-level characteristics (socioeconomic disadvantage index, residential instability index, and racial/language homogeneity index) were significantly associated with living in a hotspot of poor sustained viral suppression. CONCLUSION: These findings highlight that spatial variation in sustained viral suppression exists within the county. Targeted strategies that address structural factors and the needs of people with HIV living in specified geographic areas may improve their HIV health outcomes and contribute towards local, regional, and national goals of ending the HIV epidemic.
BACKGROUND: Identifying geographic locations most affected by the HIV epidemic is essential to addressing disparities that impact people living with HIV. This study sought to identify individual and neighborhood-level factors that are associated with residing in geographic hotspots of poor sustained HIV viral suppression. METHODS: Using data from the Miami-Dade County Ryan White HIV/AIDS program, spatial autocorrelation of poor sustained viral suppression (at least 1 laboratory test ≥ 200 copies/ml in 2017) was investigated using Global Moran's I followed by Local Moran's I and Getis Ord Gi* statistics by ZIP code tabulation areas (ZCTAs). Subsequently, multivariable logistic regression analysis was conducted to identify factors associated with residing in geographic hotspots of poor sustained viral suppression. RESULTS: Several ZCTAs in the northern part of the county, accounting for 1/3 of the Ryan White program clients, had significantly higher clustering of poor sustained viral suppression. Client-level sociodemographic characteristics such as race/ethnicity, age, and poverty, and neighborhood-level characteristics (socioeconomic disadvantage index, residential instability index, and racial/language homogeneity index) were significantly associated with living in a hotspot of poor sustained viral suppression. CONCLUSION: These findings highlight that spatial variation in sustained viral suppression exists within the county. Targeted strategies that address structural factors and the needs of people with HIV living in specified geographic areas may improve their HIV health outcomes and contribute towards local, regional, and national goals of ending the HIV epidemic.
Authors: Diana M Sheehan; Kristopher P Fennie; Daniel E Mauck; Lorene M Maddox; Spencer Lieb; Mary Jo Trepka Journal: AIDS Patient Care STDS Date: 2017-04 Impact factor: 5.078
Authors: Kevin A Jefferson; Laura S Kersanske; Mary E Wolfe; Sarah L Braunstein; Regine Haardörfer; Don C Des Jarlais; Aimee N C Campbell; Hannah L F Cooper Journal: AIDS Behav Date: 2017-10
Authors: Gary Marks; Lytt I Gardner; Charles E Rose; Anne Zinski; Richard D Moore; Susan Holman; Allan E Rodriguez; Meg Sullivan; Thomas P Giordano Journal: AIDS Date: 2015-05-15 Impact factor: 4.177
Authors: Elena Cyrus; Christyl Dawson; Kristopher P Fennie; Diana M Sheehan; Daniel E Mauck; Mariana Sanchez; Lorene M Maddox; Mary Jo Trepka Journal: Int J Environ Res Public Health Date: 2017-03-09 Impact factor: 3.390
Authors: Hanna B Demeke; Qingwei Luo; Ruth E Luna-Gierke; Mabel Padilla; Gladys Girona-Lozada; Sandra Miranda-De León; John Weiser; Linda Beer Journal: Int J Environ Res Public Health Date: 2019-12-25 Impact factor: 3.390
Authors: Adam W Carrico; Emily M Cherenack; Leah H Rubin; Roger McIntosh; Delaram Ghanooni; Jennifer V Chavez; Nichole R Klatt; Robert H Paul Journal: Psychosom Med Date: 2022-08-28 Impact factor: 3.864