Understanding disparities in viral suppression among Black MSM living with HIV in Atlanta Georgia.

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Publisher: John Wiley & Sons, Inc.
Document Type: Report
Length: 8,385 words
Lexile Measure: 1550L

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Abstract :

Introduction: Due to factors associated with structural racism, Black men who have sex with men (MSM) living with HIV are ess likely to be virally suppressed compared to white MSM. Most of these data come from clinical cohorts and modifiable reasons for these racial disparities need to be defined in order to intervene on these inequities. Therefore, we examined factors associated with racial disparities in baseline viral suppression in a community-based cohort of Black and white MSM living with HIV in Atlanta, GA. Methods: We conducted an observational cohort of Black and white MSM living with HIV infection in Atlanta. Enrolment occurred from June 2016 to June 2017 and men were followed for 24 months; laboratory and behavioural survey data were collected at 12 and 24 months after enrolment. Explanatory factors for racial disparities in viral suppression included sociode-mographics and psychosocial variables. Poisson regression models with robust error variance were used to estimate preva-ence ratios (PR) for Black/white differences in viral suppression. Factors that diminished the PR for race by [greater than or equal to]5% were considered to meaningfully attenuate the racial disparity and were included in a multivariable model. Results: Overall, 26% (104/398) of participants were not virally suppressed at baseline. Lack of viral suppression was significantly more prevalent among Black MSM (33%; 69/206) than white MSM (19%; 36/192) (crude Prevalence Ratio (PR) = 1.6; 95% CI: 1.1 to 2.5). The age-adjusted Black/white PR was diminished by controlling for: ART coverage (12% decrease), housing stability (7%), higher income (6%) and marijuana use (6%). In a multivariable model, these factors cumulatively mitigated the PR for race by 21% (adjusted PR = 1.1 [95% CI: 0.8 to 1.6]). Conclusions: Relative to white MSM, Black MSM living with HIV in Atlanta were less likely to be virally suppressed. This disparity was explained by several factors, many of which should be targeted for structural, policy and individual-level interventions to reduce racial disparities. Keywords: viral suppression; racial disparities; men who have sex with men; care cascade; HIV

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Gale Document Number: GALE|A660000738