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Durable Viral Suppression Among Young Adults Living with HIV Receiving Ryan White Services in New York City

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Abstract

Identifying factors associated with durable viral suppression (DVS) can inform interventions to support young adults living with HIV (YALWH) in sustaining optimal health. We examined associations between client characteristics and DVS among YALWH aged 18–29 who completed an intake assessment and received ≥ 1 Ryan White Part A service in New York City from 1/2017 to 12/2019. Individuals were classified as achieving DVS at least once if they had ≥ 2 suppressed viral load test results ≥ 90 days apart with: (a) no intervening unsuppressed viral load test results in a 12-month period; and (b) no unsuppressed viral load test results after achieving DVS in that 12-month period. Of 2208 YALWH, 92.1% (n = 2034) had sufficient data in the New York City HIV Surveillance Registry to ascertain DVS status. Of these, 68% achieved DVS at least once. Controlling for ART prescription status at intake, YALWH with higher incomes were significantly more likely to achieve DVS at least once. YALWH with lifetime and recent histories of incarceration and/or drug use were significantly less likely to achieve DVS. Our findings underscore the potential role of tailored harm reduction and post-incarceration programs in reducing health inequities among YALWH.

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Acknowledgements

The authors would like to thank Sarah Braunstein and the HIV Epidemiology Program for providing the Registry data and the New York Eligible Metropolitan Area Ryan White providers for reporting client assessment and services data to the NYC DOHMH. We would also like to thank Martina Pavlicova and Cale Basaraba from the Mailman School of Public Health, Columbia University Irving Medical Center for their guidance on the statistical analysis for this study.

Funding

This work was supported by the National Institute of Mental Health (P30MH043520; PI: Remien; P30MH043520-31S3; PD: Feldman; T32MH19139; PI: Sandfort).

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Authors and Affiliations

  1. New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, Queens, NY, USA

    Matthew B. Feldman, Noelisa Montero & Jacinthe A. Thomas

  2. HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY, USA

    Susie Hoffman, Nadia Nguyen, Cody L. Lentz, Stephen Sukumaran & Claude A. Mellins

  3. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Susie Hoffman

  4. Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA

    Claude A. Mellins

  5. JEVS Human Services, 1845 Walnut Street, Philadelphia, PA, 19103, USA

    Matthew B. Feldman

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  1. Matthew B. Feldman
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Contributions

M.F developed the research question, designed the analysis, and led the writing. N.M and J.T contributed to the study design and conducted the data analyses. S.H, N.N, and C.M contributed to the study design and contributed to the writing and critical revisions of the article. C.L and S.S contributed to the writing and critical revision of the article.

Corresponding author

Correspondence to Matthew B. Feldman.

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This project was reviewed and approved by the Institutional Review Boards at the New York City Department of Health and Mental Hygiene and the New York State Psychiatric Institute/Department of Psychiatry, Columbia University Irving Medical Center.

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Feldman, M.B., Montero, N., Thomas, J.A. et al. Durable Viral Suppression Among Young Adults Living with HIV Receiving Ryan White Services in New York City. AIDS Behav 27, 3197–3205 (2023). https://doi.org/10.1007/s10461-023-04040-0

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