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CLINICAL OUTCOMES OF US YOUNG BLACK MEN WITH HIV RECEIVING MEDICAL CARE, 2009–2014
Pranesh P. Chowdury1, Linda Beer1, R. L. Shouse1, Heather Bradley1
1CDC, Atlanta, GA, USA
Nearly one-third of HIV diagnoses among blacks in the United States in 2015 occurred among young people aged 15–24 years, and three-quarters were among men. Viral suppression, which greatly reduces the risk of HIV transmission, increased from 72% in 2009 to 80% in 2013 among persons in HIV care. National data on viral suppression or other clinical outcomes among young black men in HIV care are lacking.
We analyzed 2009–2014 Medical Monitoring Project (MMP) interview and medical record data collected from 336 black men aged 18–24 years. MMP is a surveillance system that produces nationally representative information about adults with diagnosed HIV in the US. We estimated the proportion of young black men in HIV care who were virally suppressed at last test (current viral suppression) and at all tests in the previous 12 months (durable viral suppression). We also estimated the proportion prescribed antiretroviral therapy (ART) and adherent to ART. We assessed changes over time in all clinical outcomes and certain characteristics associated with each outcome.
During 2009–2014, 60% of young black men in HIV care were currently virally suppressed, and 36% had durable viral suppression. There was no significant change over time in either viral suppression measure. ART prescription increased from 61% in 2009–2010 to 88% in 2013–2014 (β=0.13, P for trend <0.05). Overall, 73% of young black men were adherent to ART; this did not change significantly over time. Current viral suppression was lower among the 45% of young black men who used injection or non-injection drugs than among those who did not (49% vs. 68%, P <0.05). Durable HIV viral suppression was lower among the 12% of young black men who were homeless compared with those who were not homeless (23% vs. 38%, P <0.05) and also lower among those who used injection or non-injection drugs than among those who did not (28% vs. 42%, P <0.05). ART adherence was lower among the 20% of young black men who had current depression compared with who did not (53% vs. 78%, P <0.05) and among those who were homeless compared with those who were not (56% vs. 75%, P <0.05).
Viral suppression among young black men in HIV care was much lower than in the overall population receiving HIV care, and there were no increases in viral suppression or ART adherence among this group during 2009–2014. Improving viral suppression is essential to ensure health and reduce HIV transmission in this key population.