An exploratory study to characterize the HIV testing-to-care continuum to improve outcomes for Black and Latinx residents of South Los Angeles
South Los Angeles (SPA6), with mostly Black (27.4%) and Latinx (68.2%) residents, has the second highest rates of new HIV diagnoses (31 per 100,000) in Los Angeles County. However, there is limited understanding of the HIV testing-to-care continuum among newly diagnosed in this setting. We conducted...
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| Veröffentlicht in: | PloS one 2022-08, Vol.17 (8), p.e0268374 |
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| creator | McAndrew, Breann M Gil, Noemi Lee, David P Teklehaimanot, Senait Schrode, Katrina M Bailey, Shanelle Jordan, Wilbert Spencer, LaShonda Y Rothman, Ellen Harawa, Nina T Daniels, Joseph |
| description | South Los Angeles (SPA6), with mostly Black (27.4%) and Latinx (68.2%) residents, has the second highest rates of new HIV diagnoses (31 per 100,000) in Los Angeles County. However, there is limited understanding of the HIV testing-to-care continuum among newly diagnosed in this setting.
We conducted an exploratory study that analyzed de-identified data, including demographic characteristics and biomedical outcomes, from the electronic medical records of individuals newly diagnosed with HIV from 2016-2020 at the only public safety-net, county-run health department HIV clinic in SPA 6. We used Pearson Chi-square and Fisher's Exact test to explore associations with HIV outcomes and a Kaplan-Meier survival curve to assess the time to linkage to care.
A total of 281 patients were identified. The majority (74.1%) presented with a baseline CD4 |
| doi_str_mv | 10.1371/journal.pone.0268374 |
| format | Article |
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We conducted an exploratory study that analyzed de-identified data, including demographic characteristics and biomedical outcomes, from the electronic medical records of individuals newly diagnosed with HIV from 2016-2020 at the only public safety-net, county-run health department HIV clinic in SPA 6. We used Pearson Chi-square and Fisher's Exact test to explore associations with HIV outcomes and a Kaplan-Meier survival curve to assess the time to linkage to care.
A total of 281 patients were identified. The majority (74.1%) presented with a baseline CD4 <500, many of which presented with a CD4<200 (39.2%). We found twice as many newly diagnosed Black individuals in our study population (48.2%) when compared to LAC (23%), despite only accounting for 27.4% of residents in SPA 6. The majority were linked to care within 30 days of positive test and prescribed anti-retroviral therapy. Viral suppression (59.8%) and undetectable VL (52.6%) were achieved within the year following diagnosis, with 9.3% lost to follow-up. Of those who became virally suppressed, 20.7% experienced viral rebound within the year following diagnosis.
The large proportion of patients with a baseline CD4 <500 raises concerns about late diagnoses. Despite high rates of linkage to care and ART prescription, achievement of sustained viral suppression remains low with high rates of viral rebound. Longitudinal studies are needed to understand the barriers to early testing, retention in care, and treatment adherence to develop strategies and interventions with community organizations that respond to the unique needs of people living with HIV in South Los Angeles.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0268374</identifier><identifier>PMID: 36040966</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Ambulatory care ; Antiretroviral therapy ; Biology and Life Sciences ; Care and treatment ; CD4 antigen ; Clinical outcomes ; Community organizations ; Computer and Information Sciences ; Continuity of Patient Care ; Diagnosis ; Disease prevention ; Electronic health records ; Electronic medical records ; Ethnicity ; Gender identity ; Health care ; Health risks ; HIV ; HIV (Viruses) ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Testing ; Human immunodeficiency virus ; Humans ; Longitudinal studies ; Los Angeles - epidemiology ; Medical diagnosis ; Medical records ; Medical tests ; Medicine and health sciences ; Patients ; Population studies ; Prevention ; Public health ; Public safety ; Race ; Review boards ; Self report ; Sexual orientation ; Sustained Virologic Response ; Transgender persons ; Viral Load ; Womens health</subject><ispartof>PloS one, 2022-08, Vol.17 (8), p.e0268374</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 McAndrew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 McAndrew et al 2022 McAndrew et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-afe47145c0d12ee04acabfd5ca33af095e82b4c0a6be89491af02ac93f224e3c3</citedby><cites>FETCH-LOGICAL-c692t-afe47145c0d12ee04acabfd5ca33af095e82b4c0a6be89491af02ac93f224e3c3</cites><orcidid>0000-0002-0985-5916</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9426881/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9426881/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23864,27922,27923,53789,53791,79370,79371</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36040966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Zaller, Nickolas</contributor><creatorcontrib>McAndrew, Breann M</creatorcontrib><creatorcontrib>Gil, Noemi</creatorcontrib><creatorcontrib>Lee, David P</creatorcontrib><creatorcontrib>Teklehaimanot, Senait</creatorcontrib><creatorcontrib>Schrode, Katrina M</creatorcontrib><creatorcontrib>Bailey, Shanelle</creatorcontrib><creatorcontrib>Jordan, Wilbert</creatorcontrib><creatorcontrib>Spencer, LaShonda Y</creatorcontrib><creatorcontrib>Rothman, Ellen</creatorcontrib><creatorcontrib>Harawa, Nina T</creatorcontrib><creatorcontrib>Daniels, Joseph</creatorcontrib><title>An exploratory study to characterize the HIV testing-to-care continuum to improve outcomes for Black and Latinx residents of South Los Angeles</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>South Los Angeles (SPA6), with mostly Black (27.4%) and Latinx (68.2%) residents, has the second highest rates of new HIV diagnoses (31 per 100,000) in Los Angeles County. However, there is limited understanding of the HIV testing-to-care continuum among newly diagnosed in this setting.
We conducted an exploratory study that analyzed de-identified data, including demographic characteristics and biomedical outcomes, from the electronic medical records of individuals newly diagnosed with HIV from 2016-2020 at the only public safety-net, county-run health department HIV clinic in SPA 6. We used Pearson Chi-square and Fisher's Exact test to explore associations with HIV outcomes and a Kaplan-Meier survival curve to assess the time to linkage to care.
A total of 281 patients were identified. The majority (74.1%) presented with a baseline CD4 <500, many of which presented with a CD4<200 (39.2%). We found twice as many newly diagnosed Black individuals in our study population (48.2%) when compared to LAC (23%), despite only accounting for 27.4% of residents in SPA 6. The majority were linked to care within 30 days of positive test and prescribed anti-retroviral therapy. Viral suppression (59.8%) and undetectable VL (52.6%) were achieved within the year following diagnosis, with 9.3% lost to follow-up. Of those who became virally suppressed, 20.7% experienced viral rebound within the year following diagnosis.
The large proportion of patients with a baseline CD4 <500 raises concerns about late diagnoses. Despite high rates of linkage to care and ART prescription, achievement of sustained viral suppression remains low with high rates of viral rebound. Longitudinal studies are needed to understand the barriers to early testing, retention in care, and treatment adherence to develop strategies and interventions with community organizations that respond to the unique needs of people living with HIV in South Los Angeles.</description><subject>Ambulatory care</subject><subject>Antiretroviral therapy</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>CD4 antigen</subject><subject>Clinical outcomes</subject><subject>Community organizations</subject><subject>Computer and Information Sciences</subject><subject>Continuity of Patient Care</subject><subject>Diagnosis</subject><subject>Disease prevention</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Ethnicity</subject><subject>Gender identity</subject><subject>Health care</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Testing</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Longitudinal studies</subject><subject>Los Angeles - epidemiology</subject><subject>Medical diagnosis</subject><subject>Medical records</subject><subject>Medical tests</subject><subject>Medicine and health sciences</subject><subject>Patients</subject><subject>Population studies</subject><subject>Prevention</subject><subject>Public health</subject><subject>Public safety</subject><subject>Race</subject><subject>Review boards</subject><subject>Self report</subject><subject>Sexual orientation</subject><subject>Sustained Virologic Response</subject><subject>Transgender persons</subject><subject>Viral Load</subject><subject>Womens 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exploratory study to characterize the HIV testing-to-care continuum to improve outcomes for Black and Latinx residents of South Los Angeles</title><author>McAndrew, Breann M ; Gil, Noemi ; Lee, David P ; Teklehaimanot, Senait ; Schrode, Katrina M ; Bailey, Shanelle ; Jordan, Wilbert ; Spencer, LaShonda Y ; Rothman, Ellen ; Harawa, Nina T ; Daniels, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-afe47145c0d12ee04acabfd5ca33af095e82b4c0a6be89491af02ac93f224e3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Ambulatory care</topic><topic>Antiretroviral therapy</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>CD4 antigen</topic><topic>Clinical outcomes</topic><topic>Community organizations</topic><topic>Computer and Information Sciences</topic><topic>Continuity of Patient Care</topic><topic>Diagnosis</topic><topic>Disease prevention</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Ethnicity</topic><topic>Gender identity</topic><topic>Health care</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV (Viruses)</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Testing</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Longitudinal studies</topic><topic>Los Angeles - epidemiology</topic><topic>Medical diagnosis</topic><topic>Medical records</topic><topic>Medical tests</topic><topic>Medicine and health sciences</topic><topic>Patients</topic><topic>Population studies</topic><topic>Prevention</topic><topic>Public health</topic><topic>Public safety</topic><topic>Race</topic><topic>Review boards</topic><topic>Self report</topic><topic>Sexual orientation</topic><topic>Sustained Virologic Response</topic><topic>Transgender 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and Latinx residents of South Los Angeles</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2022-08-30</date><risdate>2022</risdate><volume>17</volume><issue>8</issue><spage>e0268374</spage><pages>e0268374-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>South Los Angeles (SPA6), with mostly Black (27.4%) and Latinx (68.2%) residents, has the second highest rates of new HIV diagnoses (31 per 100,000) in Los Angeles County. However, there is limited understanding of the HIV testing-to-care continuum among newly diagnosed in this setting.
We conducted an exploratory study that analyzed de-identified data, including demographic characteristics and biomedical outcomes, from the electronic medical records of individuals newly diagnosed with HIV from 2016-2020 at the only public safety-net, county-run health department HIV clinic in SPA 6. We used Pearson Chi-square and Fisher's Exact test to explore associations with HIV outcomes and a Kaplan-Meier survival curve to assess the time to linkage to care.
A total of 281 patients were identified. The majority (74.1%) presented with a baseline CD4 <500, many of which presented with a CD4<200 (39.2%). We found twice as many newly diagnosed Black individuals in our study population (48.2%) when compared to LAC (23%), despite only accounting for 27.4% of residents in SPA 6. The majority were linked to care within 30 days of positive test and prescribed anti-retroviral therapy. Viral suppression (59.8%) and undetectable VL (52.6%) were achieved within the year following diagnosis, with 9.3% lost to follow-up. Of those who became virally suppressed, 20.7% experienced viral rebound within the year following diagnosis.
The large proportion of patients with a baseline CD4 <500 raises concerns about late diagnoses. Despite high rates of linkage to care and ART prescription, achievement of sustained viral suppression remains low with high rates of viral rebound. Longitudinal studies are needed to understand the barriers to early testing, retention in care, and treatment adherence to develop strategies and interventions with community organizations that respond to the unique needs of people living with HIV in South Los Angeles.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36040966</pmid><doi>10.1371/journal.pone.0268374</doi><tpages>e0268374</tpages><orcidid>https://orcid.org/0000-0002-0985-5916</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2022-08, Vol.17 (8), p.e0268374 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Ambulatory care Antiretroviral therapy Biology and Life Sciences Care and treatment CD4 antigen Clinical outcomes Community organizations Computer and Information Sciences Continuity of Patient Care Diagnosis Disease prevention Electronic health records Electronic medical records Ethnicity Gender identity Health care Health risks HIV HIV (Viruses) HIV Infections - diagnosis HIV Infections - drug therapy HIV Infections - epidemiology HIV Testing Human immunodeficiency virus Humans Longitudinal studies Los Angeles - epidemiology Medical diagnosis Medical records Medical tests Medicine and health sciences Patients Population studies Prevention Public health Public safety Race Review boards Self report Sexual orientation Sustained Virologic Response Transgender persons Viral Load Womens health |
| title | An exploratory study to characterize the HIV testing-to-care continuum to improve outcomes for Black and Latinx residents of South Los Angeles |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T22%3A15%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20exploratory%20study%20to%20characterize%20the%20HIV%20testing-to-care%20continuum%20to%20improve%20outcomes%20for%20Black%20and%20Latinx%20residents%20of%20South%20Los%20Angeles&rft.jtitle=PloS%20one&rft.au=McAndrew,%20Breann%20M&rft.date=2022-08-30&rft.volume=17&rft.issue=8&rft.spage=e0268374&rft.pages=e0268374-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0268374&rft_dat=%3Cgale_plos_%3EA715527678%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2708226009&rft_id=info:pmid/36040966&rft_galeid=A715527678&rft_doaj_id=oai_doaj_org_article_cdf4b18587794ff5b4062dda763ff2e7&rfr_iscdi=true |