Associations of Routinely Collected Measures of Socioeconomic Disadvantage With Longitudinal Care Continuum Outcomes in a Clinical Cohort of Persons With HIV in the United States.

Abstract

<b>Objectives.</b> To examine the associations of routinely collected measures of socioeconomic disadvantage with HIV care continuum outcomes in 2024. <b>Methods.</b> In a cohort of people with HIV in Baltimore, Maryland, we compared restricted mean time spent in 4 states of the longitudinal care continuum (viral suppression, nonsuppression, having a 12-month gap in viral load monitoring, and death) by income, housing status, incarceration, insurance, and neighborhood deprivation. <b>Results.</b> All measures of socioeconomic disadvantage were associated with fewer days spent alive and more days with a nonsuppressed viral load. Individual income and neighborhood deprivation were independently associated with survival and viral suppression: among participants in low-deprivation neighborhoods, those with lower income spent 7 more days with a nonsuppressed viral load (95% confidence interval [CI] = 0, 16) and 2 fewer days alive (95% CI = 0, 4); among participants with higher income, those living in higher-deprivation neighborhoods spent 14 more days with a nonsuppressed viral load (95% CI = 4, 24) and 2 fewer days alive (95% CI = 0, 5). <b>Conclusions.</b> The routine collection of data on socioeconomic disadvantage can help assess risk of poor clinical outcomes among persons with HIV. (<i>Am J Public Health</i>. Published online ahead of print August 13, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308484).