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Social and Structural Factors Associated with Sustained Viral Suppression Among Heterosexual Black Men with Diagnosed HIV in the United States, 2015–2017

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Abstract

This paper describes sociodemographic, sexual risk behavior, and clinical care factors associated with sustained viral suppression (SVS) among heterosexual Black men with diagnosed HIV in the US. Sample was 968 men, 2015–2017 cycles of Medical Monitoring Project. We used prevalence ratios and a multivariable logistic regression model to identify independent predictors of SVS. About 9% of sexually active men had sex that carries a risk of HIV transmission. Nearly 2/3 lived at or below the poverty level, 13% were under or uninsured, 1/4 experienced food insecurity and 15% reported recent homelessness. About 26% were not engaged in HIV care, 8% not currently taking antiretroviral therapy (ART) and 59% had SVS. Among men taking ART, care engagement and adherence were the only significant independent predictors of SVS. Efforts to increase VS should focus on increasing ART use, care engagement, and ART adherence, and include strategies that address the social and structural factors that influence them.

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Acknowledgements

We thank MMP participants, project area staff, and Provider and Community Advisory Board members. We also acknowledge the contributions of the Clinical Outcomes Team and Behavioral and Clinical Surveillance Branch at the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Donna Hubbard McCree, Linda Beer & Yunfeng Tie

  2. Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA

    Angelica Geter Fugerson & Erin L. P. Bradley

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  1. Donna Hubbard McCree
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  2. Linda Beer
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Correspondence to Donna Hubbard McCree.

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McCree, D.H., Beer, L., Fugerson, A.G. et al. Social and Structural Factors Associated with Sustained Viral Suppression Among Heterosexual Black Men with Diagnosed HIV in the United States, 2015–2017. AIDS Behav 24, 2451–2460 (2020). https://doi.org/10.1007/s10461-020-02805-5

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  • DOI: https://doi.org/10.1007/s10461-020-02805-5

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