- Viral suppression rates among people living with HIV (PLWH) in the United States improved ~3-fold during 1997-2015.
- Large disparities in viral suppression continue to persist among younger or black PLWH.
Why this matters
- Earlier initiation of antiretroviral therapy (ART, especially at HIV diagnosis) promotes viral suppression and care retention, especially among PLWH who may be receiving care in lower resource settings.
- Evolving use of integrase strand transfer inhibitors (ISTIs) contributed to recent improved viral suppression trends.
- 31,930 PLWH with >1 viral load (VL) measure post-1997.
- Viral suppression increased from 32% to 86% during time frame.
- Adjusted analyses in patients receiving ART linked black race (OR=1.68; P<.001 and increased odds of detectable vl.>
- Using VL as a continuous outcome, black race (OR=1.60; P<.001 younger age p were associated with higher vl.>
- Conversely, Hispanic race (OR=0.89; P<.001 isti use p with lower relative vl.>
- Longitudinal, observational cohort study examining changes in HIV viral suppression over time (1997-2015) and association of viral suppression with changing demographic characteristics.
- Funding: National Institutes on Alcohol Abuse and Alcoholism at NIH.
- Self-reported adherence, sensitivity classification bias in 1997 measures.
- Residual bias (loss to follow-up).
- Clinical site differences.