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Use of recommended preventive health care services and variations in HIV care among women with HIV in the United States, 2013-2014: Opportunities for expanded partnerships in support of ending the HIV epidemic

Background: Despite recommendations for preventive health services and routine HIV care for HIV-positive women, limited data are available regarding uptake of recommendations. Methods: We used data from the 2013-2014 data cycles of the Medical Monitoring Project. We calculated weighted estimates and used multivariable logistic regression with adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to examine associations between preventive health screenings, routine HIV care (based on viral load (VL) and CD4 measures as proxies), and sociodemographic factors. Results: Of 2,766 women, 47.7% were ≥ 50 years old, 61.7% non-Hispanic black, 37.2% had > high school education, 63.3% had been living with HIV for ≥ 10 years, 68.4% were living ⩽the federal poverty level, 67.3% had public health insurance; 93.8%were prescribed antiretroviral therapy (ART); 66.1%had sustained/durable suppression (12 months). For women aged ≥ 18 years, cervical cancer, breast cancer, and STI screenings were documented for 44.3%, 27.6%, and 34.7%, respectively; 26% did not meet 6-month, and 37% did not meet 12-month, VL and CD4 test measure goals. In multivariable analyses, women with no VLs in past 6 months were less likely to be durably suppressed, and women who did not have ≥ three CD4 or VL tests (past 12 months) were less likely to be living above the poverty level, and more likely to have public insurance, compared to private health insurance (p < 0.05). Conclusion: Receipt of recommended preventive care was suboptimal. Targeted interventions are warranted to help ensure access to comprehensive HIV care and prevention services for women.