Engagement in HIV care among HIV-positive men who have sex with men from 21 cities in the United States

AIDS Behav. 2014 Apr:18 Suppl 3:348-58. doi: 10.1007/s10461-013-0605-y.

Abstract

We assessed factors associated with HIV care among HIV-infected men who have sex with men (MSM). We used 2008 data on MSM from the National HIV Behavioral Surveillance System (NHBS). Venue-based, time-space sampling was used to recruit and interview men in 21 U.S. cities with high AIDS prevalence. Among self-reported HIV-positive MSM, we used generalized estimating equations (clustered on city of interview) to evaluate factors associated with delayed linkage to care (care entry >3 months after diagnosis), not currently receiving care (no visit for HIV care during the 6 months before the study interview), and not being on antiretroviral therapy (ART). Among 8,153 MSM, 882 (11 %) were self-reported HIV-positive. 25 % had delayed linkage, 12 % were not currently receiving care and among those with at least one heath care visit 30 % were not on ART. In multivariate analysis, lower income and testing positive at their first HIV test were associated with delayed linkage. Age 18-29 years, and not having health insurance were associated with not currently receiving care. Among those with at least one health care visit, being age 18-39 years, having private or no health insurance, and stimulant use were associated with not being on ART. These findings can inform efforts to improve engagement in care.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods*
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Homosexuality, Male*
  • Humans
  • Interviews as Topic
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Population Surveillance
  • Prevalence
  • Risk-Taking
  • Urban Health / statistics & numerical data
  • Young Adult

Substances

  • Anti-Retroviral Agents