Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 26, 2019
Date Accepted: Feb 10, 2020
Date Submitted to PubMed: Feb 11, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Temporal and geographic variability in time from HIV diagnosis to viral suppression in Alabama, 2012-2014
ABSTRACT
Background:
Evaluation of the time from HIV diagnosis to viral suppression (VS) captures the collective effectiveness of HIV prevention and treatment activities in a given locale and provides a more global estimate of how effectively the larger HIV care system is working in a given geographic area or jurisdiction.
Objective:
To evaluate temporal and geographic variability in VS among persons with newly diagnosed HIV infection in Alabama in 2012-2014.
Methods:
With data from the National HIV Surveillance System, we evaluated median time from HIV diagnosis to VS (<200 c/mL) overall and stratified by Alabama public health area (PHA) among persons with HIV diagnosed during 2012-2014 using the Kaplan-Meier approach.
Results:
Among 1,979 newly diagnosed persons, 1,181 (59.7%) achieved VS within 12 months of diagnosis; 52.6% in 2012, 59.5% in 2013, and 66.9% in 2014. Median time from HIV diagnosis to VS was 8 months; 10 months in 2012, 8 months in 2013, and 6 months in 2014. Across 11 PHAs in Alabama, 12-month VS ranged from 45.8% to 83.9%, and median time from diagnosis to VS ranged from five to 13 months.
Conclusions:
Temporal improvement in persons achieving VS following HIV diagnosis statewide in Alabama is encouraging. However, considerable geographic variability warrants further evaluation to inform public health action. Time from HIV diagnosis to VS represents a meaningful indicator that can be incorporated into public health surveillance and programming.
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