Individual, community, and structural factors associated with linkage to HIV care among people diagnosed with HIV in Tennessee.

Autor: Aima A Ahonkhai, Peter F Rebeiro, Cathy A Jenkins, Michael Rickles, Mekeila Cook, Donaldson F Conserve, Leslie J Pierce, Bryan E Shepherd, Meredith Brantley, Carolyn Wester
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: PLoS ONE, Vol 17, Iss 3, p e0264508 (2022)
Druh dokumentu: article
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0264508
Popis: ObjectiveWe assessed trends and identified individual- and county-level factors associated with individual linkage to HIV care in Tennessee (TN).MethodsTN residents diagnosed with HIV from 2012-2016 were included in the analysis (n = 3,751). Individuals were assigned county-level factors based on county of residence at the time of diagnosis. Linkage was defined by the first CD4 or HIV RNA test date after HIV diagnosis. We used modified Poisson regression to estimate probability of 30-day linkage to care at the individual-level and the contribution of individual and county-level factors to this outcome.ResultsBoth MSM (aRR 1.23, 95%CI 0.98-1.55) and women who reported heterosexual sex risk factors (aRR 1.39, 95%CI 1.18-1.65) were more likely to link to care within 30-days than heterosexual males. Non-Hispanic Black individuals had poorer linkage than White individuals (aRR 0.77, 95%CI 0.71-0.83). County-level mentally unhealthy days were negatively associated with linkage (aRR 0.63, 95%CI: 0.40-0.99).ConclusionsRacial disparities in linkage to care persist at both individual and county levels, even when adjusting for county-level social determinants of health. These findings suggest a need for structural interventions to address both structural racism and mental health needs to improve linkage to care and minimize racial disparities in HIV outcomes.
Databáze: Directory of Open Access Journals
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