Timothy W Menza|Lindsay K Hixson|Lauren Lipira|Linda L. Drach
Social Determinants of Health and Care Outcomes Among People With HIV in the United States
Oregon Health Authority|Oregon Health & Science University|Oregon Health Authority|Oregon Health Authority|Portland State University|Oregon Health Authority
fewer 70 people hiv pwh united states achieved durable viral suppression end hiv epidemic united states clinicians researchers public health practitioners must devise ways remove barriers effective hiv treatment identify pwh experience challenges accessing health care created simple assessment social determinants health sdoh among pwh examined impact cumulative social economic disadvantage key hiv care outcomeswe used data 20152019 medical monitoring project yearly crosssectional survey pwh united states n 15 964 created 10item index sdoh assessed differences hiv care outcomes missed medical appointments medication adherence durable viral suppression sdoh using index using prevalence ratios predicted marginal meanseightythree percent pwh reported least 1 sdoh indicator compared pwh experienced none sdoh indicators people experienced 1 2 3 4 sdoh indicators 16 21 26 36 likely miss medical appointment prior year 11 17 20 31 less likely report excellent adherence prior 30 days 2 4 10 20 less likely achieve durable viral suppression prior year respectivelyamong pwh cumulative exposure social economic disadvantage impacts care outcomes dosedependent fashion simple index may identify pwh experiencing barriers hiv care adherence durable viral suppression need critical supportive services