社区因素对南卡罗来纳州新确诊成人 HIV 患者病毒载量可检测时的生存时间的影响。
Neighborhood Matters: Impact on Time Living with Detectable Viral Load for New Adult HIV Diagnoses in South Carolina.
机构信息
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
出版信息
AIDS Behav. 2020 Apr;24(4):1266-1274. doi: 10.1007/s10461-019-02734-y.
We examined the association between neighborhood disadvantages and percent person-time spent with increased transmission risk (VL > 1500 copies/ml) for people living with HIV (PLWH) in South Carolina (SC). The study population included PLWH diagnosed between 1/1/2014 and 12/31/2017, with two or more VL tests 6 months apart (n = 2076). Proportion of time living with VL > 1500 copies/ml after linkage to care was determined. Neighborhood disadvantage was assessed using the area deprivation index (ADI). A generalized linear model was fit to generate parameter estimates for time spent with detectable VL. Almost half of PLWH (49.5%) lived with VL > 1500 copies/ml for some time (median days = 46). Young adults and PLWH who injected drugs experienced the highest proportion for time living with detectable VL. Targeted programs are needed to improve VL suppression, reduce new transmissions and decrease disparities in HIV outcomes in all neighborhoods.
我们考察了南卡罗来纳州（SC）艾滋病毒感染者（PLWH）生活的社区劣势与病毒载量（VL）超过 1500 拷贝/ml 的比例（即存在增加传播风险的时间比例）之间的关联。该研究人群包括在 2014 年 1 月 1 日至 2017 年 12 月 31 日期间被诊断为 HIV 阳性，且在 6 个月内进行了两次或两次以上 VL 检测的患者（n=2076）。我们确定了从获得医疗服务到 VL 检测值仍超过 1500 拷贝/ml 的时间比例。采用地区剥夺指数（ADI）评估社区劣势。使用广义线性模型来计算 VL 可检测时间的参数估计值。近一半的 PLWH（49.5%）在某些时间（中位数天数=46）存在 VL 超过 1500 拷贝/ml 的情况。青年和曾注射吸毒的 PLWH 存在 VL 可检测时间比例最高。需要开展有针对性的项目，提高病毒载量抑制率，减少新的传播，并减少所有社区中 HIV 结果的差异。
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