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Factors Associated with Viral Suppression among Racial/Ethnic Minority Women in the Miami-Dade County Ryan White Program, 2017.

BACKGROUND
The study's objective was to identify factors associated with differences in the rate of viral suppression among minority women with HIV/AIDS in care in the Miami-Dade County Ryan White Program (RWP).


METHODS
A retrospective cohort study was conducted using social characteristics and laboratory data of minority women enrolled in the Miami-Dade County RWP in 2017. Viral suppression was defined as <200 copies/ml using the last viral load test of 2017. Multilevel logistic regression models were used to estimate adjusted odds ratio (aOR) and 95% confidence intervals (CI).


RESULTS
Of the 1550 racial/ethnic minority women in the study population, 43.1% were African American, 31.3% were Hispanic, and 25.6% were Haitian. The proportion of women virally suppressed was lower among African Americans (80.8%) than among Hispanics (86.4%) and Haitians (85.1%). Viral suppression rates were significantly lower among women aged 18-34 years (aOR: 0.41, CI: 0.27-0.64) and 35-49 years (0.63, 0.45-0.90) vs. ≥50 years, US born (0.48, 0.30-0.78), having a household income of <100% the federal poverty level (0.54, 0.30-0.95), previously diagnosed with AIDS (0.60, 0.44-0.81), reporting problematic drug use (0.23, 0.08-0.69), and living in a residentially unstable neighborhood (0.77, 0.64-0.93). Race/ethnicity was not associated with viral suppression after adjusting for other factors.


CONCLUSION
Factors associated with lack of viral suppression were similar among minority racial/ethnic groups. Interventions at the individual level focusing on young, US-born and those who report drug use, and at the neighborhood level for those living in residentially unstable neighborhoods are needed to improve viral suppression outcomes.