Characterizing residential mobility among people living with HIV in tennessee and its impact on HIV care outcomes.

Our objective was to assess the prevalence and patterns of mobility among people living with HIV (PWH) in Tennessee, and its impact on HIV care outcomes. Retrospective cohort study. We combined residential address and HIV surveillance data from PWH in Tennessee from 2016 to 2018. Using Poisson regression, we estimated associations between in-state mobility (change in address or total miles moved) in one year and outcomes in the subsequent year; retention: having two CD4/HIV RNA values (labs) in a calendar year at least three months apart, loss to follow-up (LTFU): having labs at baseline but not the subsequent year, and viral suppression: HIV RNA <200 copies/mL. We applied a kernel density estimator to origin-destination address lines to visualize mobility patterns across demographic subgroups. Among 17,428 PWH (median age 45 years [IQR 34, 53]), 6,564 (38%) had ≥1 move. Median miles moved was 8.9 (IQR 2.6, 143.4)). We observed in-state movement between major cities (Chattanooga, Knoxville, Memphis and Nashville) and out-of-state movement to and from Georgia and Florida. Having ≥1 in-state moves was associated with a decreased likelihood of retention (adjusted relative risk [aRR]=0.91; 95%CI 0.88-0.95), and an increased risk of LTFU (aRR=1·17; 95%CI 1·04-1·31 2-3 moves vs. none). Greater distance moved in-state was associated with decreased retention and increased LTFU (aRR=0.53; 95%CI 0.49-0.58, aRR=2.52; 95%CI 2.25-2.83 respectively for 1000 vs. 0 miles). There was no association between mobility and viral suppression. Mobility is common among PWH in Tennessee and is associated with initial poor engagement in HIV care.

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.