Department of Social Work, University of Alabama at Birmingham, Birmingham, AL, United States.
ICF International, Fairfax, VA, United States.
JMIR Public Health Surveill. 2020 May 22;6(2):e17217. doi: 10.2196/17217.
Evaluation of the time from HIV diagnosis to viral suppression (VS) captures the collective effectiveness of HIV prevention and treatment activities in a given locale and provides a more global estimate of how effectively the larger HIV care system is working in a given geographic area or jurisdiction.
This study aimed to evaluate temporal and geographic variability in VS among persons with newly diagnosed HIV infection in Alabama between 2012 and 2014.
With data from the National HIV Surveillance System, we evaluated median time from HIV diagnosis to VS (<200 c/mL) overall and stratified by Alabama public health area (PHA) among persons with HIV diagnosed during 2012 to 2014 using the Kaplan-Meier approach.
Among 1979 newly diagnosed persons, 1181 (59.67%) achieved VS within 12 months of diagnosis; 52.6% (353/671) in 2012, 59.5% (377/634) in 2013, and 66.9% (451/674) in 2014. Median time from HIV diagnosis to VS was 8 months: 10 months in 2012, 8 months in 2013, and 6 months in 2014. Across 11 PHAs in Alabama, 12-month VS ranged from 45.8% (130/284) to 84% (26/31), and median time from diagnosis to VS ranged from 5 to 13 months.
Temporal improvement in persons achieving VS following HIV diagnosis statewide in Alabama is encouraging. However, considerable geographic variability warrants further evaluation to inform public health action. Time from HIV diagnosis to VS represents a meaningful indicator that can be incorporated into public health surveillance and programming.
从 HIV 诊断到病毒抑制（VS）的时间评估，捕捉了特定地区内 HIV 预防和治疗活动的整体效果，并提供了一个更全面的估计，说明在特定地理区域或司法管辖区内，更大的 HIV 护理系统的工作效率如何。
本研究旨在评估 2012 年至 2014 年期间，阿拉巴马州新诊断 HIV 感染者达到 VS 的时间的时空变异性。
利用国家 HIV 监测系统的数据，我们使用 Kaplan-Meier 方法，评估了在 2012 年至 2014 年期间诊断出 HIV 的人群中，按阿拉巴马州公共卫生区（PHA）分层的，从 HIV 诊断到 VS（<200 c/mL）的中位数时间。
在 1979 名新诊断的患者中，有 1181 名（59.67%）在诊断后 12 个月内达到 VS；2012 年为 52.6%（353/671），2013 年为 59.5%（377/634），2014 年为 66.9%（451/674）。从 HIV 诊断到 VS 的中位数时间为 8 个月：2012 年为 10 个月，2013 年为 8 个月，2014 年为 6 个月。在阿拉巴马州的 11 个 PHAs 中，12 个月的 VS 从 45.8%（130/284）到 84%（26/31）不等，从诊断到 VS 的中位数时间从 5 个月到 13 个月不等。
阿拉巴马州全州范围内 HIV 感染者达到 VS 的时间有所改善，这令人鼓舞。然而，显著的地域差异需要进一步评估，以指导公共卫生行动。从 HIV 诊断到 VS 的时间是一个有意义的指标，可以纳入公共卫生监测和规划。
