Use of Recommended Preventive Health Care Services and Variations in HIV Care Among Women With HIV in the United States, 2013-2014: Opportunities for Expanded Partnerships in Support of Ending the HIV Epidemic

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 82; no. 3; p. 234
• Main Authors: Short, William R, Sutton, Madeline Y, Luo, Qingwei, Frazier, Emma L
• Format: Journal Article
• Language: English
• Published: United States 01.11.2019
• Subjects: Adolescent; Adult; Anti-Retroviral Agents - therapeutic use; Breast Neoplasms - epidemiology; CD4 Lymphocyte Count; Female; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - therapy; Humans; Insurance, Health; Logistic Models; Middle Aged; Patient Participation; Prevalence; Preventive Health Services - statistics & numerical data; Sexually Transmitted Diseases - epidemiology; Socioeconomic Factors; United States - epidemiology; Uterine Cervical Neoplasms - epidemiology; Viral Load; Young Adult; United States
• ISSN: 1944-7884
• DOI: 10.1097/QAI.0000000000002141

Despite recommendations for preventive health services and routine HIV care for HIV-positive women, limited data are available regarding uptake of recommendations. We used data from the 2013-2014 data cycles of the Medical Monitoring Project. We calculated weighted estimates and used multivariable logistic regression with adjusted prevalence ratios and 95% confidence intervals to examine associations between preventive health screenings, routine HIV care [based on viral load (VL) and CD4 measures as proxies], and sociodemographic factors. Of 2766 women, 47.7% were 50 years and older, 61.7% non-Hispanic black, 37.2% had >high school education, 63.3% had been living with HIV for ≥10 years, 68.4% were living ≤the federal poverty level, 67.3% had public health insurance, 93.8% were prescribed antiretroviral therapy, and 66.1% had sustained/durable suppression (12 months). For women aged 18 years and older, cervical cancer, breast cancer, and sexually transmitted infection screenings were documented for 44.3%, 27.6%, and 34.7%, respectively; 26% did not meet 6-month, and 37% did not meet 12-month, VL and CD4 test measure goals. In multivariable analyses, women with no VLs in the past 6 months were less likely to be durably suppressed, and women who did not have ≥3 CD4 or VL tests (past 12 months) were less likely to be living above the poverty level and more likely to have public insurance compared with private health insurance (P < 0.05). Receipt of recommended preventive care was suboptimal. Targeted interventions are warranted to help ensure access to comprehensive HIV care and prevention services for women.