Heterosexuals living in neighborhoods with a lower percentage of residents who are food distressed are more likely to maintain HIV viral suppression compared with those living in areas where a larger percentage of residents are food distressed, according to a study published in AIDS Care.

Studies show that heterosexuals are less likely to achieve and maintain HIV viral suppression compared with men who have sex with men.2,3 Recently, researchers have begun to investigate whether a patient’s environment might affect suppression.4-8 Thus, researchers conducted multilevel analyses to examine associations between United Hospital Fund-level characteristics (eg, food distress, demographic composition, neighborhood disadvantage and affluence, healthcare access, alcohol outlet density, residential vacancy, and police stop and frisk rates) and individual-level viral suppression and durable viral suppression among 3159 heterosexuals living in New York City who were newly diagnosed with HIV between 2009 and 2013.

They found that 57% of all newly diagnosed individuals in this analysis achieved HIV viral suppression within 12 months of diagnosis, but only 36.15% were durably suppressed during that time. The researchers also found that living in neighborhoods where less than 1% of residents were food distressed was marginally associated with suppression and was associated with durable suppression. Living in neighborhoods with a low percentage (<5%) of residents who were black was also associated with achieving viral suppression after HIV diagnosis.

The authors concluded that, “To inform interventions, future multilevel research should explore associations in longitudinal panels or cohorts between the percent of residents who are [b]lack, the percent of residents who are food distressed, and HIV viral suppression, and analyze the causal pathways through which these place-based exposures affect viral suppression outcomes.”

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References

  1. Jefferson KA, Kersanske LS, Wolfe ME, et al. Place-based predictors of HIV viral suppression and durable suppression among heterosexuals in New York city. AIDS Care. 2018:1-11.
  2. Crepaz N, Tang T, Marks G, Mugavero MJ, Espinoza L, Hall HI. Durable viral suppression and transmission risk potential among persons with diagnosed HIV infection: United States, 2012-2013. Clin Infect Dis. 2016;63(7):976-983.
  3. Hall HI, Frazier EL, Rhodes P, et al. Differences in human immunodeficiency virus care and treatment among subpopulations in the United States. JAMA Intern Med. 2013;173(14):1337-1344.
  4. Beattie C. Structural barriers to HIV viral load suppression at an urban HIV/AIDS care center. Paper presented at the 143rd APHA Annual Meeting and Exposition; Chicago, IL; November 3, 2015. Abstract 321223.
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  7. Shacham E, Lian M, Onen NF, Donovan M, Overton ET. Are neighborhood conditions associated with HIV management? HIV Med. 2013;14(10):624-632.
  8. Wiewel EW. Association of neighborhood-level socioeconomic status (SES) with time from HIV diagnosis to viral suppression among newly diagnosed New Yorkers, 2006–2010. Paper presented at the 142nd APHA Annual Meeting and Exposition; New Orleans, LA; November 18, 2014. Abstract 300295.