Presentation Title

Disparities in HIV Care, Small and Large Cities in Georgia, 2009-2014

Abstract

Data from the Georgia Medical Monitoring Project was used to characterize and identify disparities among people living with HIV (PLWH) receiving outpatient HIV care in small and large cities in Georgia. This project combines clinical and behavioral data to identify disparities by location and opportunities to improve treatment outcomes for all PLWH in Georgia.

Proposal Summary

BACKGROUND: HIV surveillance data show disparities in treatment outcomes for people living with HIV (PLWH) in rural areas nationally and in Georgia. METHODS: We used data from the Georgia Medical Monitoring Project (GA MMP) to characterize disparities by location among PLWH receiving care at Ryan White HIV/AIDS Program-funded (RWHAP) facilities from 2009-2014. Location of HIV care was dichotomized as a small (< 100,000 people) or large (≥ 100,000 people) city based on facility address. Negative beliefs about antiretroviral therapy (ART) were measured by self-reported doubt in ability to take ART as directed or its positive effect on health. RESULTS: Among 720 participants, the 225 (31%) who received HIV care in small cities, compared to those in large cities, were more likely to be female (39% vs. 25%, small vs. large cities, p<0.01) and to identify as heterosexual (65% vs. 45%, respectively, p<0.01) and were less likely to have a high school degree (77% vs. 86%, respectively, p <0.01). More PLWH expressed negative beliefs about ART in small cities (20% vs. 12%, small vs. large, p<0.001). Participants with negative beliefs about ART were significantly less likely to achieve durable viral suppression (DVS) than those with positive beliefs in small city facilities (34% vs. 69% DVS, respectively, p<0.01), but not in large city facilities. CONCLUSIONS: Negative ART beliefs may contribute to poorer HIV treatment outcomes in small cities and rural areas. Further understanding and addressing this disparity would promote progress towards the updated National HIV/AIDS Strategy goals.

Relevance And Significance

This proposal addresses both the “Clinical Research” and “Prevention and Intervention” conference tracks. First, this project describes demographic and clinical characteristics of a representative sample of PLWH in both small and large cities in Georgia. The data for the project was collected through a state-wide HIV surveillance and monitoring system, contributing valuable information to the surveillance topic within the “Clinical Research” track. In addition, our results contribute to the “Prevention and Intervention” track through both describing the epidemiology of HIV in Georgia and characterizing the experiences of PLWH across the state. Georgia MMP’s rich combination of data from personal interviews and medical record abstractions provides a unique opportunity for the HIV care community to identify and address disparities among Georgians living with HIV across the state.

Session Format

Poster Session

Keywords

Disparities in HIV outcomes by location, antiretroviral therapy, viral suppression, HIV surveillance, Ryan White HIV/AIDS Program

Publication Type and Release Option

Presentation (Open Access)

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Disparities in HIV Care, Small and Large Cities in Georgia, 2009-2014

Data from the Georgia Medical Monitoring Project was used to characterize and identify disparities among people living with HIV (PLWH) receiving outpatient HIV care in small and large cities in Georgia. This project combines clinical and behavioral data to identify disparities by location and opportunities to improve treatment outcomes for all PLWH in Georgia.