Sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression in the Miami-Dade County Ryan White Program, 2017.
Sex differences in psychosocial and demographic factors associated with sustained HIV viral suppression in the Miami-Dade County Ryan White Program, 2017.
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迈阿密戴德县 Ryan White 计划中与持续艾滋病病毒抑制相关的社会心理和人口因素的性别差异，2017 年。
DOI：
10.1080/09540121.2022.2080800
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发表时间：
2023
期刊：
影响因子：
1.7
通讯作者：
Trepka,MaryJo
中科院分区：
文献类型：
--
作者：
Ward,MelissaK;Fernandez,SofiaB;Sheehan,DianaM;Li,Tan;Dawit,Rahel;Fennie,Kristopher;Beach,MaryCatherine;Brock,Petra;Ladner,Robert;Trepka,MaryJo
这项探索性研究考察了与持续HIV病毒抑制(SVS)相关的心理社会和人口因素的性别差异。研究人群包括2017年接受服务的6,489名迈阿密-戴德·瑞安·怀特计划(RWP)客户；对管理数据进行了分析。SVS被定义为2017年所有病毒载量测试低于200拷贝/毫升。多水平Logistic回归模型按医疗病例管理地点进行聚集。模特是按性别分层的。总体而言，女性没有达到SVS的比例(23.5%)高于男性(18.1%)。对于女性(n = 1,503)，在围产期感染艾滋病毒以及没有伴侣或成年家庭成员与无法实现SVS相关。对于男性(n = 4,986)，无法获得食物、黑人或海地种族/族裔、有问题的药物使用以及不知名的医生与无法实现SVS有关。无论男女，较年轻的年龄、较低的家庭收入、曾经被诊断为艾滋病、感到抑郁或焦虑以及经历无家可归与没有达到SVS有关。应进一步探讨从青少年艾滋病毒护理向成人艾滋病毒护理过渡过程中可能对女性客户产生不同影响的因素以及与披露有关的因素。男性客户可能需要额外的食品安全支持。还应探讨改善对海地和非西班牙裔黑人男性客户的特定文化关怀。
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.