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Gender, age variations observed in HIV cascade of care

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PHILADELPHIA — Despite improvements for all subpopulations in the cascade of care for HIV over time, there are significant variations in success by age and gender, according to a presentation at IDWeek 2014.

“Retention in care, ART prescription and viral suppression improved annually for all age groups and genders,” Michael Horberg, MD, MAS, of the Mid-Atlantic Permanente Research Group, said during his presentation. “Improvement may be related to multidisciplinary care teams, electronic health records, continual quality measurement and quality improvement, and high medication adherence rates.”

Michael Horberg

Horberg and colleagues evaluated the cascades of care for patients with HIV aged 13 years and older within the Kaiser Permanente health care system. All patients were members of the system for at least 8 months in 2010 (n=16,816), 2011 (n=17,711) and 2012 (n=18,249). The researchers evaluated linkage to care, retention in care, ART treatment and viral suppression and compared the cascades by year, and by gender and age.

They found that men had a higher percentage of linkage to care, prescription of ART and viral suppression in both 2010 and 2011, but not in 2012. Females, however, had a significantly greater retention in care for all years. Increasing age was significantly associated with a higher percentage of retention in care, prescription of ART and viral suppression for all years.

Horberg identified two limitations of the study: The number of undiagnosed HIV infections is unknown, and the study was not done in real time, which is a plan for the future.

“The take-home message is that success varies significantly by age and gender, even in an integrated care system with equal access to care,” Horberg said. “Stratified cascades can help identify subpopulations requiring more targeted outreach. Programs targeting our younger-aged HIV population are warranted.” - by Emily Shafer

For more information:

Horberg M. Abstract 88. Presented at: IDWeek 2014; Oct. 8-12; Philadelphia.

Disclosure: Horberg reports no relevant financial disclosures.