title: Disparities in engagement in care and viral suppression among persons with HIV.
abstract: BACKGROUND
  Engagement across the spectrum of HIV care can improve health outcomes and prevent HIV transmission. We used HIV surveillance data to examine these outcomes.
  
  
  METHODS
  San Francisco residents who were diagnosed with HIV between 2009 and 2010 were included. We measured the characteristics and proportion of persons linked to care within 6 months of diagnosis, retained in care for second and third visits, and virally suppressed within 12 months of diagnosis.
  
  
  RESULTS
  Of 862 persons included, 750 (87%) entered care within 6 months of diagnosis; of these, 72% had a second visit in the following 3-6 months; and of these, 80% had a third visit in the following 3-6 months. Viral suppression was achieved in 50% of the total population and in 76% of those retained for 3 visits. Lack of health insurance and unknown housing status were associated with not entering care (P < 0.01). Persons with unknown insurance status were less likely to be retained for a second visit; those younger than 30 years were less likely to be retained for a third visit. Independent predictors of failed viral suppression included age <40 years, homelessness, unknown housing status, and having a single or 2 medical visits compared with 3 visits.
  
  
  CONCLUSIONS
  Socioeconomic resources and age, not race or gender, are associated with disparities in engagement in HIV care in San Francisco.
authors: University of California, San Francisco, CA, USA.
authors: Dharushana
authors: D
authors: Muthulingam
authors: Jennie
authors: J
authors: Chin
authors: Ling
authors: L
authors: Hsu
authors: Susan
authors: S
authors: Scheer
authors: Sandra
authors: S
authors: Schwarcz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012367:RNA, Viral / Q000097:blood*; D012495:San Francisco / Q000453:epidemiology; D012959:Socioeconomic Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D012367:RNA, Viral