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Role of Gay Neighborhood Status and Other Neighborhood Factors in Racial/Ethnic Disparities in Retention in Care and Viral Load Suppression Among Men Who Have Sex with Men, Florida, 2015

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Abstract

This study‘s objective was to examine the role of gay neighborhood residence and other neighborhood factors in racial/ethnic disparities in retention in HIV care and viral load suppression during 2015. Florida residents diagnosed 2000–2014 with HIV infection and with transmission mode of men who have sex with men (MSM) were included in multi-level logistic regression models. Of 29,156 MSM, 29.4% were not retained and 34.2% were not virally suppressed. Non-Hispanic Blacks (NHB) had a higher likelihood of not being retained (adjusted prevalence ratio [aPR] 1.31, 95% confidence interval [CI] 1.24–1.38, p value < 0.0001) and not being virally suppressed (aPR 1.82, 95% CI 1.67–1.98, p value < 0.0001) compared with non-Hispanic Whites. Among NHBs, rural residence was protective for both outcomes. Although gay neighborhood residence was not associated with either outcome, the role of other neighborhood factors suggests that individual and neighborhood barriers to HIV care and treatment should be addressed among MSM.

Resumen

El objetivo de este estudio fue examinar el rol de residencia de vecindad gay y otros factores de vecindad en disparidades raciales/étnicas en la retención en el cuidado médico de VIH y la supresión de carga viral durante 2015. Los residentes de Florida diagnosticados con la infección de VIH 2000-2014 y con el modo de transmisión de hombres que tienen sexo con hombres (HSH) fueron incluidos en modelos de regresión logísticos de niveles múltiples. De 29,156 HSH, el 29.4% no fue retenido y el 34.2% no tuvo supresión de carga viral. Los Negros no Hispanos tuvieron una probabilidad más alta de no ser retenidos (razón de prevalencia ajustada [RPa] 1.31, intervalo de confianza de 95% [IC] 1.24–1.38, p valor < 0.0001) y de no tener la carga viral suprimida (RPa 1.82, 95% IC 1.67–1.98, p valor < 0.0001) comparado con Blancos no Hispanos. Entre Negros no Hispanos, residencia rural fue protectora para ambos resultados. Aunque la residencia de vecindad gay no fue asociada con ningún resultado, la función de otros factores de vecindad sugiere que barreras al cuidado y tratamiento de VIH a nivel del individuo y vecindad deberían de ser atendidos entre HSH.

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Acknowledgements

Research reported in this publication was supported by the National Institute on Minority Health & Health Disparities (NIMHD) under Award Number 5R01MD004002. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMHD or the National Institutes of Health. The authors thank Merhawi Gebrezgi for his assistance with the analysis.

Funding

This study was funded by the National Institute on Minority Health & Health Disparities (NIMHD) under Award Number 5R01MD004002.

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Authors and Affiliations

  1. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA

    Daniel E. Mauck, Diana M. Sheehan, Kristopher P. Fennie & Mary Jo Trepka

  2. Center for Research on US Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL, USA

    Diana M. Sheehan

  3. HIV/AIDS Section, Florida Department of Health, Tallahassee, FL, USA

    Lorene M. Maddox

  4. Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC 5, Room 487, Miami, FL, 33199, USA

    Mary Jo Trepka

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  1. Daniel E. Mauck
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Correspondence to Mary Jo Trepka.

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Ethical Approval

The Florida International University Institutional Review Board (IRB) approved this study and the Florida Department of Health IRB designated this study to be non-human subjects research. This study used de-identified HIV surveillance records of Florida residents. Informed consent was not required for this secondary data analysis.

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Mauck, D.E., Sheehan, D.M., Fennie, K.P. et al. Role of Gay Neighborhood Status and Other Neighborhood Factors in Racial/Ethnic Disparities in Retention in Care and Viral Load Suppression Among Men Who Have Sex with Men, Florida, 2015. AIDS Behav 22, 2978–2993 (2018). https://doi.org/10.1007/s10461-018-2032-6

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