Characterizing residential mobility among people with HIV in Tennessee and its impact on HIV care outcomes
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: Our objective was to assess the prevalence and patterns of mobility among people with HIV (PWH) in Tennessee and its impact on HIV care outcomes.
DESIGN: Retrospective cohort study.
METHODS: We combined residential address and HIV surveillance data from PWH in Tennessee from 2016 to 2018. Using Poisson regression, we estimated associations between in-state mobility (change in address or total miles moved) in 1 year and outcomes in the subsequent year; retention: having two CD4 + /HIV RNA values (labs) in a calendar year at least 3 months apart, loss to follow-up (LTFU): having labs at baseline but not the subsequent year, and viral suppression: HIV RNA less than 200 copies/ml. We applied a kernel density estimator to origin-destination address lines to visualize mobility patterns across demographic subgroups.
RESULTS: Among 17 428 PWH [median age 45 years (interquartile range; IQR 34-53)], 6564 (38%) had at least one move. Median miles moved was 8.9 (IQR 2.6-143.4)). We observed in-state movement between major cities (Chattanooga, Knoxville, Memphis and Nashville) and out-of-state movement to and from Georgia and Florida. Having at least one in-state move was associated with a decreased likelihood of retention [adjusted relative risk (aRR) = 0.91; 95% confidence interval (CI) 0.88-0.95], and an increased risk of LTFU (aRR = 1.17; 95% CI 1.04-1.31, two to three moves vs. none). Greater distance moved in-state was associated with decreased retention and increased LTFU (aRR = 0.53; 95% CI 0.49-0.58, aRR = 2.52; 95% CI 2.25-2.83, respectively for 1000 vs. 0 miles). There was no association between mobility and viral suppression.
CONCLUSION: Mobility is common among PWH in Tennessee and is associated with initial poor engagement in HIV care.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
AIDS (London, England) - 38(2024), 3 vom: 01. Feb., Seite 397-405 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ahonkhai, Aima A [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 02.02.2024 Date Revised 18.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/QAD.0000000000003778 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Characterizing residential mobility among people with HIV in Tennessee and its impact on HIV care outcomes |
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| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Our objective was to assess the prevalence and patterns of mobility among people with HIV (PWH) in Tennessee and its impact on HIV care outcomes | ||
| 520 | |a DESIGN: Retrospective cohort study | ||
| 520 | |a METHODS: We combined residential address and HIV surveillance data from PWH in Tennessee from 2016 to 2018. Using Poisson regression, we estimated associations between in-state mobility (change in address or total miles moved) in 1 year and outcomes in the subsequent year; retention: having two CD4 + /HIV RNA values (labs) in a calendar year at least 3 months apart, loss to follow-up (LTFU): having labs at baseline but not the subsequent year, and viral suppression: HIV RNA less than 200 copies/ml. We applied a kernel density estimator to origin-destination address lines to visualize mobility patterns across demographic subgroups | ||
| 520 | |a RESULTS: Among 17 428 PWH [median age 45 years (interquartile range; IQR 34-53)], 6564 (38%) had at least one move. Median miles moved was 8.9 (IQR 2.6-143.4)). We observed in-state movement between major cities (Chattanooga, Knoxville, Memphis and Nashville) and out-of-state movement to and from Georgia and Florida. Having at least one in-state move was associated with a decreased likelihood of retention [adjusted relative risk (aRR) = 0.91; 95% confidence interval (CI) 0.88-0.95], and an increased risk of LTFU (aRR = 1.17; 95% CI 1.04-1.31, two to three moves vs. none). Greater distance moved in-state was associated with decreased retention and increased LTFU (aRR = 0.53; 95% CI 0.49-0.58, aRR = 2.52; 95% CI 2.25-2.83, respectively for 1000 vs. 0 miles). There was no association between mobility and viral suppression | ||
| 520 | |a CONCLUSION: Mobility is common among PWH in Tennessee and is associated with initial poor engagement in HIV care | ||
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| 700 | 1 | |a Clouse, Kate |e verfasserin |4 aut | |
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| 700 | 1 | |a Perkins, Jessica M |e verfasserin |4 aut | |
| 700 | 1 | |a Wernke, Steven A |e verfasserin |4 aut | |
| 700 | 1 | |a Shepherd, Bryan E |e verfasserin |4 aut | |
| 700 | 1 | |a Brantley, Meredith |e verfasserin |4 aut | |
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