Introduction Increase in CD4 count and achieving viral suppression are the ultimate goals of the HIV care, yet disparities in these outcomes exist among subpopulations of HIV-infected persons. We aimed to assess potential disparities in viral suppression and normal CD4 count among HIV-infected persons in care in Mississippi.
Methods We used Mississippi Medical Monitoring Project (MMP) data from 2009 to 2014 (n=1,233) in this study. MMP is a nationally representative surveillance system designed to assess and monitor the behavioural and clinical characteristics of HIV-infected adults receiving outpatient medical care in the United States. Outcome variables in this study were suppressed recent and durable viral load (<200 copies/ml), and normal CD4 count (≥500 cells/mm3). Patients’ characteristics in this study were race, gender, age, annual income, education, insurance, and length of diagnosis. Descriptive analysis, Chi-square tests, and multiple logistic regression were conducted, accounting for the complex sample design.
Results Our findings indicate that suppressed recent viral load prevalence was significantly higher among whites (72.8%), those aged ≥50 years (74.3%), those who had annual income ≥$20 000 (76%), public insurance (68.3%), or those were diagnosed ≥5 years (67.4%). The prevalence of suppressed durable viral load was significantly higher among those who aged ≥50 years (71.7%), and were diagnosed ≥5 years ago (61.4%), and the prevalence of normal CD4 was significantly higher among females (46%). Multivariable analysis show that those aged ≥50 years were more likely to have suppressed recent (aOR=2.4) and durable viral load (aOR=2.9) compared to those aged 18–24 years, and women were more likely to have normal CD4 count than men (aOR=1.4), after controlling for the confounders.
Conclusion Our findings identified age and gender disparities in the HIV clinical outcomes, which may be used to develop and implement multifaceted interventions to improve health equity among all HIV-infected patients.