Competing subsistence needs are associated with retention in care and detectable viral load among people living with HIV. Issue 3 (3rd July 2018)

• Record Type: Journal Article
• Authors: Palar, Kartika; Wong, Mitchell D.; Cunningham, William E.
• Is Part Of: Journal of HIV/AIDS & social services. Volume 17:Issue 3(2018)
• Page Start: 163
• Page End: 179
• Publication Date: 2018-07-03
• Subjects: hard-to-reach populations -- HIV -- retention in care -- subsistence needs; ART, antiretroviral therapy -- CN, competing needs -- ED, emergency department -- GEE, generalized estimating equations -- HCSUS, HIV Cost and Services Utilization Study -- HRSA, Health Resources and Services Administration -- IDU, injecting drug use/user -- IRR, incidence rate ratios -- MSM, men who have sex with men -- PLHIV, people living with HIV -- SPNS, Special Project of National Significance; AIDS (Disease) -- Social aspects -- Periodicals; AIDS (Disease) -- Patients -- Services for -- Periodicals; 362.1969792005
• DOI: 10.1080/15381501.2017.1407732
• Languages: English
• ISSNs: 1538-1501

Abstract

ABSTRACT: Competing priorities between subsistence needs and health care may interfere with HIV health. Longitudinal data from the Los Angeles-based HIV Outreach Initiative were analyzed to examine the association between competing subsistence needs and indicators of poor retention-in-care among hard-to-reach people with HIV. Sacrificing basic needs for health care in the previous six months was associated with a 1.55 times greater incidence of missed appointments (95% CI 1.17, 2.05), 2.32 times greater incidence of emergency department visits (95% CI 1.39, 3.87), 3.66 times greater incidence of not receiving ART if CD4 < 350 (95% CI 1.60, 8.37), and 1.35 times greater incidence of detectable viral load (95% CI 1.07, 1.70) (all p < 0.01). Among hard-to-reach PLHIV, sacrificing basic needs for health care delineates a population with exceptional vulnerability to poor outcomes along the HIV treatment cascade. Efforts to identify and reduce competing needs for this population are crucial to HIV health outcomes.