Among men who have sex with men (MSM) living with HIV in Atlanta, Black men are more likely than white men to have a detectable viral load, aidsmap reports. However, researchers identified a number of risk factors, such as access to health care and housing instability, that if modified could eliminate the race-based disparity in the viral suppression rate.
Justin Knox, PhD, MPH, of Columbia University presented findings from the Engagement Study, a community-based prospective cohort study, at the 2020 Conference on Retroviruses and Opportunistic Infections in Boston earlier this month.
The study included 398 HIV-positive Black and white MSM in Atlanta between 2016 and 2017.
Fifty-two percent of the participants were Black. Fifty-five percent of the Black men and 33% of the white men were younger than 40 years old. About half of the Black men and 29% of the white men had an income below $20,000. A respective 30% and 17% of each group had unstable housing; 15% and 7% had been incarcerated in the past year; 14% and 5% did not have insurance or government program coverage for their antiretroviral (ARV) treatment; 62% and 27% used marijuana; and 23% and 12% used crystal meth.
Thirty-three percent of the Black men had a detectable viral load, meaning a viral load of 40 or higher, compared with 19% of the white men. This meant that being Black, compared with being white, was associated with a 60% greater likelihood of having a detectable viral load.
After adjusting the data to account for differences in the men’s ages, the study authors analyzed modifiable risk factors and found that having insurance coverage for ARV treatment reduced the Black-to-white disparity in the likelihood of having an undetectable viral load by 12%. Having received viral load testing within the past year (which served as a proxy for being in medical care for the virus) reduced the ratio by 9%. In addition, having stable housing reduced the ratio by 7%; having an income over $20,000 reduced it by 6%; and not using marijuana reduced it by 6%.
All told, modifying all these factors would reduce the disparity by 23%, thus eliminating the difference in the viral suppression rates between the white and Black men.
To read the aidsmap article, click here.
To read the conference abstract, click here.
To view a webcast of the conference presentation, click here.