Racial and socioeconomic disparities in viral suppression among persons living with HIV in New York City

Abstract

PurposeTo examine differences in racial disparities across levels of neighborhood poverty and differences in socioeconomic disparities by race/ethnicity in viral suppression among persons living with HIV (PLWH). MethodsUsing HIV surveillance data, we categorized and geocoded PLWH who were in care in New York City (NYC). Multilevel binomial regression techniques were used to model viral suppression with a two-level hierarchical structure, by including age, transmission risk, year of diagnosis, race/ethnicity, census tract poverty, and an interaction term of race/ethnicity and census tract poverty in the model. ResultsThere were 30,638 Blacks, 22,921 Hispanics, and 11,695 Whites living with HIV and retained in care in NYC, 2014. Compared with Blacks living in the most impoverished neighborhoods (≥30% residents living below the federal poverty level) who had the lowest proportion of viral suppression, with 75% in males and 76% in females, Whites living in the least impoverished neighborhoods (<10% residents living below the federal poverty level) had the highest, with 92% in males (prevalence ratio = 1.16; 95% confidence interval: 1.13, 1.18) and 90% in females (PR = 1.14; 95% CI: 1.09, 1.19). ConclusionsBy examining racial and socioeconomic disparities simultaneously, we were able to detect both disparities in viral suppression among PLWH in NYC.