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. 2018 Jan 2;13(1):e0189973.
doi: 10.1371/journal.pone.0189973. eCollection 2018.

Trends of racial and ethnic disparities in virologic suppression among women in the HIV Outpatient Study, USA, 2010-2015

Angelica Geter  1 , Madeline Y Sutton  1 , Carl Armon  2 , Marcus D Durham  1 , Frank J Palella Jr  3 , Ellen Tedaldi  4 , Rachel Hart  2 , Kate Buchacz  1 ; HIV Outpatient Study Investigators
Affiliations

Trends of racial and ethnic disparities in virologic suppression among women in the HIV Outpatient Study, USA, 2010-2015

Angelica Geter et al. PLoS One. .

Erratum in

Abstract

In the United States, women accounted for 19% of new HIV diagnoses in 2015 and were less likely to reach virologic suppression when compared to men. We assessed trends and disparities in virologic suppression among HIV-positive women to inform HIV treatment strategies. Data were from a prospective cohort of the HIV Outpatient Study and collected at nine United States HIV clinics. We included women aged ≥18 years, with ≥1 visit, who were prescribed antiretroviral therapy, and had ≥1 viral load test performed between 2010 and 2015. We defined virologic suppression as viral load <50 copies/mL and calculated adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) for virologic suppression by race/ethnicity and year of measure. Generalized estimating equations were used for multivariable analyses to assess factors associated with virologic suppression. Among 809 women (median age = 44 years), 482 (60%) were black, 177 (22%) white, 150 (19%) Hispanic/Latina. Virologic suppression was less prevalent among black women (73%) compared with Hispanic/Latina women (83%) and white women (91%). In multivariable analyses, not achieving virologic suppression was more likely among black women (aPR = 2.13; CI = 1.50-3.02) or Hispanic/Latina women (aPR = 1.66; CI = 1.08-2.56) compared with white women, and among women who attended public clinics (aPR = 1.42; CI = 1.07-1.87) compared with those who attended a private clinic. Between 2010 and 2015, virologic suppression among HIV-positive women increased from 68% to 83%, but racial/ethnic disparities persisted. Black and Hispanic/Latina women had significantly lower rates of virologic suppression than white women. Interventions targeting virologic suppression improvement among HIV-positive women of color, especially those who attend public clinics, are warranted.

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Conflict of interest statement

Competing Interests: We have the following interests: Rachel Hart and Carl Armon are employed by Cerner Corporation. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Fig 1
Fig 1. Selection steps flowchart of HOPS participants included in the analysis.
Fig 2
Fig 2. Trends of viral suppression among women by race/ethnicity, the HIV Outpatient Study, USA, 2010–2015 (N = 809).
Proportion confidence intervals were obtained using the OpenEpi version 3.01 Mid-P Exact Method.
Fig 3
Fig 3. Trends of viral suppression by race/ethnicity, the HIV Outpatient Study, 2010–2015 (N = 809).
See this image and copyright information in PMC

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