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Predictors of Viral Suppression Among People Living with HIV in Rural Oregon

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Abstract

With recent outbreaks of HIV in rural areas of the United States, it has become increasingly important to understand the factors affecting health outcomes of people with HIV living in rural areas. We assessed predictors of durable HIV viral suppression among rural participants using a pooled 7-year dataset from the Medical Monitoring Project (MMP), a cross-sectional, representative sample of individuals receiving HIV medical care in Oregon. Only 77.3% of rural participants achieved durable HIV viral suppression, while 22.7% had at least one detectable HIV viral load measurement within the past 12 months. The primary predictors of viral suppression were ARV adherence, poverty, and reported heavy drinking in the past 30 days. These results highlight the influence of social factors on health outcomes for persons with HIV living in rural areas and inform areas for policy and program change.

Resumen

Con los brotes recientes de VIH en áreas rurales de los Estados Unidos, se ha vuelto cada vez más importante comprender los factores que afectan los resultados de salud de las personas con VIH que viven en áreas rurales. Evaluamos los predictores de la supresión viral del VIH duradera entre los participantes rurales utilizando un conjunto de datos combinados de siete años del Proyecto de Monitoreo Médico (MMP), una muestra transversal y representativa de personas que reciben atención médica para el VIH en Oregón. Solo el 77,3% de los participantes rurales logró una supresión viral del VIH duradera, mientras que el 22,7% tuvo al menos una medición detectable de la carga viral del VIH en los últimos 12 meses. Los predictores primarios de la supresión viral fueron la adherencia a los ARV, la pobreza y el consumo excesivo de alcohol informado en los últimos 30 días. Estos resultados destacan la influencia de los factores sociales en los resultados de salud de las personas con VIH que viven en áreas rurales e informan las áreas para el cambio de políticas y programas.

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Funding

This work was supported by the Centers for Disease Control and Prevention [5NU62PS004959-04-00 to TWM].

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Authors and Affiliations

  1. Public Health Division, Oregon Health Authority, Portland, OR, USA

    Timothy W. Menza & Lindsay K. Hixson

  2. Division of Infectious Diseases, Department of Medicine, Oregon Health and Science University, Portland, OR, USA

    Timothy W. Menza

  3. School of Public Health, Oregon Health and Science University-Portland State University, Portland, OR, USA

    Ann Jensen

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Contributions

TWM conceptualized the study; TWM and AJ devised the statistical analysis plan; TWM and AJ wrote the first draft of the manuscript; LKH provided critical revisions to the manuscript; and all authors contributed significantly to intellectual content of the final manuscript.

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Correspondence to Timothy W. Menza.

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In accordance with guidelines for defining public health research, CDC and OHA have determined MMP is public health surveillance used for disease control, program, or policy purposes.

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Menza, T.W., Jensen, A. & Hixson, L.K. Predictors of Viral Suppression Among People Living with HIV in Rural Oregon. AIDS Behav 28, 154–163 (2024). https://doi.org/10.1007/s10461-023-04145-6

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