TY - JOUR
T1 - Factors Associated with Geographic Patterns of Poor Sustained Viral Suppression in Miami-Dade County Florida, 2017
AU - Dawit, Rahel
AU - Trepka, Mary Jo
AU - Duncan, Dustin T.
AU - Gbadamosi, Semiu O.
AU - Li, Tan
AU - Pires, Stephen F.
AU - Ladner, Robert A.
AU - Sheehan, Diana M.
N1 - Funding Information:
This research is supported by awards from the National Institute on Minority Health and Health Disparities (NIMHD) of F31MD015234 from the National Institute of Health. This research was also supported in part by NIMHD grants [R01MD013563, R01MD012421, K01MD013770, U54MD012393, and R01MD013554]; National Institute of Mental Health grant [R01MH112406] and Centers for Disease Control and Prevention grant [U01PS005202].
Funding Information:
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.
Publisher Copyright:
© 2022, W. Montague Cobb-NMA Health Institute.
PY - 2023/2
Y1 - 2023/2
N2 - 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.
AB - 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.
KW - Geographic disparities
KW - HIV/AIDS
KW - Hotspots/cold spots
KW - Neighborhood-level factors
KW - Spatial autocorrelation
KW - Sustained viral suppression
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U2 - 10.1007/s40615-021-01227-w
DO - 10.1007/s40615-021-01227-w
M3 - Article
C2 - 35099764
AN - SCOPUS:85123925335
VL - 10
SP - 357
EP - 366
JO - Journal of racial and ethnic health disparities
JF - Journal of racial and ethnic health disparities
SN - 2197-3792
IS - 1
ER -