ARV Coverage Still Low for Some HIV-Positive Groups
While linkage to care and antiretroviral (ARV) treatment has increased nationwide among persons with HIV, black men who have sex with men (MSM) who are HIV positive continue to have the lowest prevalence in coverage, according to the findings of a recent study.
In a prior study, the researchers reported on the prevalence of linkage to care and access to ARV treatment among HIV-positive men who have sex with men using data from the 2008 and 2011 Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance (NHBS). To further monitor progress on HIV coverage, the researchers analyzed the prevalence of linkage to care and ARV treatment for 2014.
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Linkage to care was defined as a reported clinical visit within 3 months of an HIV diagnosis. A total of 236 men in 2008, 291 men in 2011, and 358 men in 2014 were included in the final analysis. For all years, linkage to care was associated with men with higher education and income, as well as current insurance. The prevalence increased from 79% in 2008 to 87% in 2014, with no difference observed by region. In addition, the researchers found that the prevalence increased from 75% in 2008 to 78% in 2014 in analyses where linkage to care was defined as a clinical visit within 1 month of HIV diagnosis.
Analysis of ARV treatment included 1142 men in 2008, 1336 men in 2011, and 1714 men in 2014. Overall, the prevalence of ARV treatment increased from 69% in 2008 to 88% in 2014. The researchers observed a higher percentage of ARV treatment among those with a higher education, income, current insurance, whites, and older age groups. While the south had the lowest prevalence of ARV treatment compared with other regions in 2008 and 2014, the difference between regions was no longer present in analysis that adjusted for race.
While positive increases in ARV treatment were observed across all groups, the researchers found a large racial disparity in coverage, with a 9% point higher prevalence among whites compared with blacks.
“Despite similar prevalences in linkage to care, blacks continue to be less likely to be prescribed ARV treatment,” the authors concluded. “Increased resources are needed to support immediate referrals for ARV treatment for all MSM newly diagnosed with HIV.”
—Melissa Weiss
Reference:
Hoots BE, Finlayson TJ, Wejnert C, Paz-Bailey G, for the National HIV Behavioral Surveillance (NHBS) Study Group. Updated data on linkage to human immunodeficiency virus care and antiretroviral treatment among men who have sex with men—20 Cities, United States. Journal Infect Dis. 2017;216(7): 808–812. https://doi.org/10.1093/infdis/jix007.