Dataset Information

Person-time spent with HIV viral load above 1500 copies/mL among Miami-Dade County Ryan White Program clients, 2017-2019: a retrospective analysis.

ABSTRACT: HIV transmission risk significantly increases at HIV viral load (VL) >1500 copies/mL. We sought to determine the percentage of person-time spent with VL >1500 copies/mL (pPT >1500) and the associations of demographic, clinical, and psychosocial factors and this outcome among persons with HIV receiving care. A retrospective analysis of data from clients enrolled in the Ryan White Program from 2017 to 2019 was performed. We assessed pPT >1500 in HIV care by utilizing consecutive VL pairs and calculating the length of time between each pair and the corresponding time spent for the observation period. The association between pPT >1500 and selected client characteristics were analyzed using a random-effects zero-inflated negative binomial model. Among the 6390 clients, 42% were aged 50 or older, 52% MSM, and 59% Hispanic. Overall, 7.5% of clients spent, on average, 27.4 days per year at substantial risk of transmitting HIV. Younger age, AIDS diagnosis, and reported drug use in the preceding 12 months were associated with higher pPT >1500. Tailored interventions should be implemented to meet the unique HIV needs of groups with consistent viremia to significantly minimize transmission risk.

SUBMITTER: Gbadamosi SO

PROVIDER: S-EPMC9885974 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Person-time spent with HIV viral load above 1500 copies/mL among Miami-Dade County Ryan White Program clients, 2017-2019: a retrospective analysis.

Gbadamosi Semiu O SO Trepka Mary Jo MJ Dawit Rahel R Bursac Zoran Z Raymond Andrea A Ladner Rober A RA Sheehan Diana M DM

Annals of epidemiology 20221221

HIV transmission risk significantly increases at HIV viral load (VL) >1500 copies/mL. We sought to determine the percentage of person-time spent with VL >1500 copies/mL (pPT >1500) and the associations of demographic, clinical, and psychosocial factors and this outcome among persons with HIV receiving care. A retrospective analysis of data from clients enrolled in the Ryan White Program from 2017 to 2019 was performed. We assessed pPT >1500 in HIV care by utilizing consecutive VL pairs and calcu ...[more]

PMID: 36563765

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Project description:Urbanization is increasing globally, and construction sites are an integral part of the urbanization process. It is unknown to what extent construction sites create favorable breeding conditions for mosquitoes. The main objectives of the present study were to identify what species of mosquitoes are present at construction sites and the respective physical features associated with their production. Eleven construction sites were cross-sectionally surveyed for the presence of mosquitoes in Miami-Dade County, Florida including in areas previously affected by the Zika virus outbreak in 2016. A total of 3.351 mosquitoes were collected; 2.680 adults and 671 immatures. Aedes aegypti and Culex quinquefasciatus comprised 95% of all collected mosquitoes and were the only species found in their immature forms breeding inside construction sites. Results for the Shannon and Simpson indices, considering both immature and adult specimens, yielded the highest values for Cx. quinquefasciatus and Ae. aegypti. The individual rarefaction curves indicated that sampling sufficiency was highly asymptotic for Cx. quinquefasciatus and Ae. aegypti, and the plots of cumulative species abundance (ln S), Shannon index (H) and log evenness (ln E) (SHE) revealed the lack of heterogeneity of species composition, diversity and evenness for the mosquitoes found breeding in construction sites. The most productive construction site breeding features were elevator shafts, Jersey plastic barriers, flooded floors and stair shafts. The findings of this study indicate that vector mosquitoes breed in high numbers at construction sites and display reduced biodiversity comprising almost exclusively Ae. aegypti and Cx. quinquefasciatus. Such findings suggest that early phase construction sites have suitable conditions for the proliferation of vector mosquitoes. More studies are needed to identify modifiable worker- and organizational-level factors to improve mosquito control practices and guide future mosquito control strategies in urban environments.

Project description:BackgroundHIV viral suppression is associated with health benefits for people living with HIV and a decreased risk of HIV transmission to others. The objective was to identify demographic, psychosocial, provider and neighborhood factors associated with sustained viral suppression among gay, bisexual, and other men who have sex with men.MethodsData from adult men who have sex with men (MSM) enrolled in the Miami-Dade County Ryan White Program (RWP) before 2017 were used. Sustained viral suppression was defined as having an HIV viral load < 200 copies/ml in all viral load tests in 2017. Three-level (individual, medical case management site, and neighborhood) cross-classified mixed-effect models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for sustained viral suppression.ResultsOf 3386 MSM, 90.8% were racial/ethnic minorities, and 84.4% achieved sustained viral suppression. The odds of achieving sustained viral suppression was lower for 18-24 and 25-34 year-old MSM compared with 35-49 year-old MSM, and for non-Latino Black MSM compared with White MSM. Those not enrolled in the Affordable Care Act, and those with current AIDS symptoms and a history of AIDS had lower odds of achieving sustained viral suppression. Psychosocial factors significantly associated with lower odds of sustained viral suppression included drug/alcohol use, mental health symptoms, homelessness, and transportation to appointment needs. Individuals with an HIV physician who serves a larger volume of RWP clients had greater odds of sustained viral suppression. Neighborhood factors were not associated with sustained viral suppression.ConclusionDespite access to treatment, age and racial disparities in sustained viral suppression exist among MSM living with HIV. Addressing substance use, mental health, and social services' needs may improve the ability of MSM to sustain viral suppression long-term. Furthermore, physician characteristics may be associated with HIV outcomes and should be explored further.

Dataset Information

Person-time spent with HIV viral load above 1500 copies/mL among Miami-Dade County Ryan White Program clients, 2017-2019: a retrospective analysis.

Publications

Person-time spent with HIV viral load above 1500 copies/mL among Miami-Dade County Ryan White Program clients, 2017-2019: a retrospective analysis.

Similar Datasets

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