The Association Between the Social Determinants of Health and HIV Control in Miami-Dade County ZIP Codes, 2017

Bibliographic Data

ID19002201
AuthorsDayana Rojas (0000-0002-9844-0850, University of Miami, corresponding author), Anamarie Garces de Marcilla (0000-0001-6368-0523, Public Health Solutions), Imelda K Moise (0000-0003-0222-780X, University of Miami), Jorge Saavedra (0000-0001-8974-7861, University of Miami), José Szapocznik (0000-0002-3832-1753, University of Miami)
Year2020
Volume8
Issue3
Pages763-772
Publication date2020-08-17
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Racial and Ethnic Health Disparities (JOURNAL)
Journal identifiersISSN: 2196-8837 • E-ISSN: 2197-3792
PublisherSpringer Science+Business Media (PUBLISHER • DE)
DOI10.1007/s40615-020-00838-z
PMID32808192
OpenAlexW3077392055
LanguageEN
Citations received10
References cited32

BACKGROUND: There were 28,055 people living with HIV (PLWH) in Miami-Dade County (MDC) in 2017; 40.1% was either out of care or was not virally suppressed (uncontrolled HIV). The purpose of this study was to determine the association between the social determinants of health (SDOH) and the number of persons with uncontrolled HIV in MDC. SETTING: This cross-sectional study included PLWH 15 and older with uncontrolled HIV in MDC, 2017. Data on PLWH's viral load, age, gender, mode of HIV transmission, and race/ethnicity were aggregated to the ZIP code level. All five SDOH per HealthyPeople 2020 were represented: economic stability, education, social and community context, health and healthcare, and neighborhood and built environment. METHODS: Descriptive analyses on all study variables and a principal component analysis on the SDOH variables were performed. To account for overdispersion, multivariate negative binomial regressions were run while controlling for confounders and testing for significant interactions. RESULTS: The results of the regression analysis indicated that an increase in Factor 1 (economic stability, education, and health and healthcare determinants) was associated with a statistically significant increase in the number of PLWH with uncontrolled HIV. Additionally, we found a significant interaction between Factor 1 and White race. Among persons of low socioeconomic status, White race is associated with a reduction in PLWH with uncontrolled HIV. CONCLUSIONS: These results suggest that reducing poverty and increasing education and rates of health insurance should result in significant reductions in PLWH with uncontrolled HIV. These results have the potential to influence future policy, interventions for retention, adherence, and continuity of care to improve suppression rates in MDC

Confounding · Environmental health · Ethnic group · Geography · Health equity · Population · Psychological intervention · Public health · Social determinants of health · Socioeconomic status · Sociology · Demography · Food Security and Health in Diverse Populations · HIV/AIDS Research and Interventions · Homelessness and Social Issues · Medicine · Gerontology