Background The Southeastern US is characterised as America’s “bible belt” with prominent religiosity yet also has the highest HIV incidence. The interplay between religion/spirituality and HIV-related outcomes could vary from detrimental to beneficial. We previously showed that men who have sex with men (MSM) who attended church were more likely to present to care with more advanced disease than those who did not. Here, we evaluate the relationship between church attendance and sustained HIV viremia 12 months after initiation of care in the Southeastern US.

Methods We evaluated 12-month longitudinal analysis was performed to evaluate the relationship between church attendance and continued viremia (viral load > 200 copies/ml) for patients presenting for care at a university HIV clinic. Univariate and multivariable logistic regression models were fit for church attendance (the main variable of interest) as well as other variables potentially related to sustained viremia.

Results Between 2007 to 2012, 382 patients initiated HIV care for the first time and had a HIV viral load available 12 months from time of care entry. Most were black (60%), MSM (65%) and at 12 months were virally suppressed (74%). In MV analyses, reported church attendance was associated with a lower likelihood of HIV viremia (AOR 0.5; 95% CI 0.2, 0.9). Variables associated with an increased likelihood of sustained HIV viremia included black race (AOR 3.2; 95% CI 1.4, 7.4), living with family (AOR 2.7; 95% CI 1.0, 6.9), and disclosure of HIV status only to family (AOR 3.0; 95% CI 1.2, 7.7) or only to friends (AOR 2.6; 95% CI 1.1, 6.7).

Conclusions Church attendance may provide much needed support for patients entering HIV care. Further research is needed to understand the complex relationship between church attendance and health care outcomes in PLWH.

Disclosure of interest statement No disclosures.