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  • Author
    Lyolya Hovhannisyan
  • Co-author

    Lara E. Coelho, Jesse Clark, Sandra W. Cardoso, Jordan Lake, Valdilea G. Veloso, Beatriz Grinsztejn, Paula M. Luz

  • Title

    High levels of viral suppression are not affected by neighborhood socioeconomic context among PLHIV in Rio de Janeiro, Brazil

  • Abstract

    Understanding the impact of neighborhood context on viral suppression (VS) outcomes may help explain health disparities and identify future interventions. We assessed the relationship between individual characteristics, neighborhood socioeconomic context, and VS using multilevel logistic regression models. Adults with HIV initiating ART between 2000 and 2017, who resided in Rio de Janeiro and had an HIV-1 RNA level (viral load) value 90-270 days after ART initiation were included. Neighborhood socioeconomic indicators were defined by the municipal human development index (MHDI) and social vulnerability index (SVI) of participants’ residence. Overall, 83.9% achieved VS. MHDI and SVI did not predict VS in unadjusted or adjusted analyses. Participants who were older, had a higher level of education, and identified as heterosexual cisgender men and cisgender men-who-have-sex-with-men had increased odds of VS. Later calendar year of ART initiation carried the strongest association with VS, reflecting the effectiveness and tolerability of ART overtime.

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