Neighborhood Characteristics Associated with Achievement and Maintenance of HIV Viral Suppression Among Persons Newly Diagnosed with HIV in New York City
Neighborhood Characteristics Associated with Achievement and Maintenance of HIV Viral Suppression Among Persons Newly Diagnosed with HIV in New York City
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DOI：
10.1007/s10461-017-1700-2
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发表时间：
2017-12-01
影响因子：
4.4
通讯作者：
Torian, Lucia V.
中科院分区：
文献类型：
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作者：
Wiewel, Ellen W.;Borrell, Luisa N.;Torian, Lucia V.
我们调查了社区特征对2006年至2012年确诊的13岁及以上纽约市（NYC）居民实现和维持HIV病毒抑制的影响。来自纽约市艾滋病毒监测登记处的个人记录（n = 12，547）与美国人口普查和美国社区调查的居住人口普查数据相关联。多变量比例风险回归模型表明的可能性，实现和维护抑制邻里特征，包括贫困，占邻里聚集和个人特征。在校正分析中，没有邻里因素与抑制的实现相关。然而，与低贫困社区的居民相比，高贫困或极高贫困社区的居民不太可能保持抑制。总之，较高的邻里贫困与较少的抑制维护。协助诊断后保留护理，抗逆转录病毒治疗处方，或坚持针对较高贫困社区的居民可能会改善纽约市病毒抑制的维持。
We investigated the effect of neighborhood characteristics on achievement and maintenance of HIV viral suppression among New York City (NYC) residents aged 13 years and older diagnosed between 2006 and 2012. Individual records from the NYC HIV surveillance registry (n = 12,547) were linked to U.S. Census and American Community Survey data by census tract of residence. Multivariable proportional hazards regression models indicated the likelihood of achievement and maintenance of suppression by neighborhood characteristics including poverty, accounting for neighborhood clustering and for individual characteristics. In adjusted analyses, no neighborhood factors were associated with achievement of suppression. However, residents of high- or very-high-poverty neighborhoods were less likely than residents of low-poverty neighborhoods to maintain suppression. In conclusion, higher neighborhood poverty was associated with lesser maintenance of suppression. Assistance with post-diagnosis retention in care, antiretroviral therapy prescribing, or adherence targeted to residents of higher-poverty neighborhoods may improve maintenance of viral suppression in NYC.