ArticleFrontiers in public health2022
Moderation effect of community health on the relationship between racial/ethnic residential segregation and HIV viral suppression in South Carolina: A county-level longitudinal study from 2013 to 2018.
Article in Frontiers in public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Changes in Racial Disparities in Viral Suppression Among People with HIV from 2013-2020: A Statewide Cohort Study.Journal of racial and ethnic health disparities · 2026Article
- Association of Racial Residential Segregation and Other Social Determinants of Health with HIV Late Presentation.AIDS and behavior · 2025Article
- Spatial and temporal analysis of HIV clinical outcomes in Florida reveals counties with persistent racial and ethnic disparities during 2012-2019.BMC public health · 2024Article
- Residential Segregation and County-Level COVID-19 Booster Coverage in the Deep South: Surveillance Report and Ecological Study.JMIR public health and surveillance · 2023Article
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10 authors.
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Abstract
Background: Viral suppression is the ultimate goal of the HIV treatment cascade and a primary endpoint of antiretroviral therapy. Empirical evidence found racial/ethnic disparities in viral suppression among people living with HIV (PWH), but the evidence of the relationship between racial/ethnic residential segregation and place-based viral suppression is scarce. Further exploring potential structural moderators in this relationship has substantial implications for healthcare policymaking and resource allocation. The current study aimed to investigate the spatial-temporal disparities in the HIV viral suppression rate across 46 counties in South Carolina from 2013 to 2018. We also examined the impact of racial/ethnic residential segregation and the moderation effect of community health, one measurement of community engagement and volunteerism. Methods: The proportion of PWH who achieved viral suppression for each county and calendar year was calculated using de-identified electronic medical records. The isolation index was calculated and used to measure racial/ethnic residential segregation. The community health index and other county-level factors were directly extracted from multiple publicly available datasets. We used geospatial mapping to explore the spatial-temporal variations of HIV viral suppression rates. Hierarchical quasi-binominal regression models were used to examine the impacts of racial/ethnic residential segregation on county-level viral suppression rate by the extent of community health. Results: From 2013 to 2018, the average viral suppression rate across 46 counties in SC increased from 64.3% to 65.4%. Regression results revealed that counties with high racial/ethnic residential segregation were more likely to have a low viral suppression rate (β = -0.56, 95% CI: -0.75 to -0.37). In counties with high levels of community health, the impact of racial/ethnic residential segregation on viral suppression rate decreased as compared with those with low levels of community health (β = 5.50, 95% CI: 0.95-10.05). Conclusions: Racial/ethnic residential segregation acts as a structural barrier to placed-based viral suppression rates and compromises the goal of the HIV treatment cascade. Concentrated and sustained county-level interventions aiming to improve community health can be practical approaches to promote health equity in HIV treatment and care.
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