Barriers to HIV Care by Viral Suppression Status Among US Adults With HIV: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project.
Sharoda Dasgupta, Yunfeng Tie, Linda Beer and 2 others
PMID 33769329WHAT IT FOUND
Among adults with HIV who felt they did not receive enough care, 95.6% reported barriers to care; in that group, those whose HIV was not suppressed were more likely to report life circumstances, money or insurance problems, and fear or denial about HIV.
Key findings
01Among the 965 adults who felt they did not receive enough HIV care, 95.6% reported at least one barrier and 62.6% reported more than one barrier.
02Adults who felt they did not receive enough care and were not virally suppressed were more likely than virally suppressed adults to report life circumstances that impeded care (56.6% vs. 39.7%), money or insurance problems (39.1% vs. 27.4%), and fear or denial about living with HIV (18.6% vs. 7.4%).
03People not virally suppressed were less likely to be retained in care (57.3% vs. 90.8%) and more likely to miss visits (31.1% vs. 20.0%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Barriers were asked only of people who felt they did not receive enough HIV care, so the results do not describe barriers among people who felt care was adequate. Care engagement and barriers were partly self-reported, so answers may be biased. Not every sampled person participated; the authors adjusted for nonresponse, but response was incomplete. Life circumstances were reported broadly, and details such as substance use, mental health, or incarceration were not known for all participants. Barrier questions may have been interpreted differently by different people. This is an observational surveillance analysis, not a trial, so it cannot show that any barrier caused unsuppressed HIV or that addressing it would improve care.
Declared interests
The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest.
The easy way to misread this
Do not conclude that these barriers caused unsuppressed HIV or that addressing them will improve viral suppression. This is a self-reported surveillance analysis of people who felt they did not receive enough care, and it did not test any intervention.