Factors Influencing Viral Suppression in Newly Diagnosed HIV Patients in Washington, D.C.

1. Factors associated with achieving viral suppression among newly diagnosed HIV/AIDS cases in Washington, D.C Willis SJ, Castel AD, Griffin A, West T, Shaikh I, Pappas G Introduction • DCDOH supports HIV test and treat activities - increased number of HIV tests performed, emphasis on earlier linkage to care. • Limited data about the impact of these efforts on viral suppression (VS). • This analysis identified factors associated with achieving VS among a cohort of newly diagnosed HIV/AIDS cases. Methods • Eligibility: HIV/AIDS cases diagnosed 2006-07, initial detectable VL followed by at least 1 additional VL test before 12/31/10. • VS was defined as <400 copies/mL • Performed bivariate analyses, multivariate LR and survival analyses to determine predictors of viral suppression. Results • 2,412 cases diagnosed between 2006-2007; 988 met eligibility criteria. • 648 of eligible cases achieved VS prior to 12/31/2010.

2. Multivariate Logistic Regression† • Results • No difference in median VL at diagnosis (achieved VS: 22,583.5 copies/mL; no VS: 18,444.0 copies/mL, p=0.42) • Individuals ≥50 yrs were 2.0 times as likely to achieve VS than 13-29 yr olds. • AIDS diagnoses were 1.7 times as likely to achieve VS than individuals diagnosed with HIV, not AIDS. • Individuals with 2+ VL tests/yr were 7.4 times as likely to achieve VS than individuals with <2 VL tests/yr. Male vs. Female Black vs. White Hispanic vs. White Other race vs. White 30-39 vs. 13-29 40-49 vs. 13-29 50-59 vs. 13-29 AIDS vs. HIV, not AIDS Continuous Care At least 2 VL tests per year vs. less than 2 VL tests per year † Odds ratio adjusted for sex, race/ethnicity, age at diagnosis, diagnostic status, continuous care, and annual viral load test rate

3. Conclusions • Engagement in care is directly associated with VS. • Individuals that are immunosuppressed at diagnosis are more likely to achieve VS - motivated to seek care, adhere to treatment, provider behavior • Individuals ≥50 years of age at diagnosis more likely to achieve VS . • Programs that emphasize engagement in care are crucial to improving health of HIV-infected persons. • Bolded values represent statistically significant values. • †Cox Proportional Hazards Ratios were adjusted for sex, race/ethnicity, age at HIV diagnosis, diagnostic status, linkage to care, continuous care, and annual VL test rate.