Online Program

288523
Effects of sava syndemic-related factors on viral suppression among HIV positive women of color receiving HIV care


Wednesday, November 6, 2013 : 11:30 a.m. - 11:45 a.m.

Kristen Sullivan, PhD, MSW, MA, Center for Health Policy and Inequalities Research, Duke University, Durham, NC
Lynne C. Messer, PhD, MPH, Community Health - Urban & Public Affairs (SCH), Portland State University, Portland, OR
Evelyn Byrd Quinlivan, MD, Center for Infectious Diseases, UNC Centers for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
Arthur E. Blank, PhD, Department of Family Medicine and Social Medicine, Center for the Evaluation of Health Programs/Division of Research, Bronx, NY
Niko Verdecias, MPH, Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
Jason J. Fletcher, PhD, Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
Background: Research suggests the interacting epidemics of substance abuse, violence, HIV/AIDS and related health and psychosocial factors create an excess burden in marginalized communities (the SAVA syndemic). This study examines the relationships between SAVA syndemic-related factors and viral suppression among HIV-positive women of color (WoC) who have received recent HIV care. Methods: Data are from the cross-site evaluation of the HRSA-funded SPNS initiative designed to engage and retain WoC in HIV care. A standardized multi-site baseline survey was employed and matched with chart abstraction data. Women were included if they had a viral load test within 90 days of the baseline survey (implying the receipt of some level of HIV care). GEEs were utilized to test the predictive value of the psychosocial/health variables on viral suppression (y/n) while accounting for the clustering of women by site. Models included the dichotomous predictor variables frequent mental distress (≥14 days of symptoms/month), substance abuse, alcohol use, history of STD(s), and intimate partner violence, controlling for demographic variables. Results: Data for 268 HIV+ WoC were analyzed; 49% (N=132) were virally suppressed. Frequent mental distress and a history of STDs decreased the odds of viral suppression (95% CI, .518,.960,α=.026, and .378,.851,α=.006, respectively). No interactive or additive effects of the SAVA-related variables were found. Conclusions: While two SAVA syndemic-related factors were found to negatively effect viral suppression, the absence of interactive or additive effects of the variables suggest that the syndemic approach may not be a viable framework for predicting HIV clinical outcomes among this population.

Learning Areas:

Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the effects of SAVA syndemic-related factors on viral suppression among HIV positive women of color receiving HIV care. Explain the syndemic approach to understanding HIV-related health disparities.

Keyword(s): HIV/AIDS, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have significant experience in research examining barriers to HIV care. Additionally, I am involved in the evaluation of one of the HRSA WoC site projects, Guide to Healing, based at UNC Chapel Hill.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5116.1: Women & HIV