HIV care cascade for women living with HIV in the Greater Toronto Area versus the rest of Ontario and Canada-Reference-Cited by-同舟云学术

HIV care cascade for women living with HIV in the Greater Toronto Area versus the rest of Ontario and Canada

Published:2022-11-21 Issue:1 Volume:34 Page:4-17
ISSN:0956-4624
Container-title:International Journal of STD & AIDS
language:en
Short-container-title:Int J STD AIDS

Author:

Medeiros Priscilla¹^ORCID,Warren Laura¹²,Kazemi Mina¹,Massaquoi Notisha³,Smith Stephanie¹,Tharao Wangari⁴,Serghides Lena¹⁵⁶,Logie Carmen H¹³^ORCID,Kroch Abigail⁷,Burchell Ann N⁸⁹,de Pokomandy Alexandra¹⁰¹¹^ORCID,Kaida Angela¹²,Loutfy Mona¹²⁹^ORCID,

Affiliation:

1. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada

2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

3. Faculty of Social Work, University of Toronto, Toronto, ON, Canada

4. Women’s Health in Women’s Hands Community Health, Toronto, ON, Canada

5. Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada

6. Department of Immunology, University of Toronto, Toronto, ON, Canada

7. Ontario HIV Treatment Network, Toronto, ON, Canada

8. Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, ON, Canada

9. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

10. Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada

11. Department of Family Medicine, McGill University, Montreal, QC, Canada

12. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

Abstract

Background The Greater Toronto Area (GTA) is home to 39% of Canada’s population living with HIV. To identify gaps in access and engagement in care and treatment, we assessed the care cascade of women living with HIV (WLWH) in the GTA versus the rest of Ontario and Canada (in this case: Quebec and British Columbia). Methods We analyzed 2013–2015 self-reported baseline data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study for six care cascade stages: linked to care, retained in care, initiated antiretroviral therapy (ART), currently on ART, ART adherence (≥90%), and undetectable (<50 copies/mL). Multivariable logistic regression was used to reveal associations with being undetectable. Results Comparing the GTA to the rest of Ontario and Canada, respectively: 96%, 98%, 100% were linked to care; 92%, 94%, 98% retained in care; 72%, 89%, 96% initiated ART; 67%, 81%, 90% were currently using ART; 53%, 66%, 77% were adherent; 59%, 69%, 81% were undetectable. Factors associated with viral suppression in the multivariable model included: living outside of the GTA (Ontario: aOR = 1.72, 95% CI: 1.09–2.72; Canada: aOR = 2.42, 95% CI: 1.62–3.62), non-Canadian citizenship (landed immigrant/permanent resident: aOR = 3.23, 95% CI: 1.66–6.26; refugee/protected person/other status: aOR = 4.77, 95% CI: 1.96–11.64), completed high school (aOR = 1.77, 95% CI: 1.15–2.73), stable housing (aOR = 2.13, 95% CI: 1.33–3.39), income of ≥$20,000 (aOR = 1.52, 95% CI: 1.00–2.31), HIV diagnosis <6 years (6–14 years: aOR = 1.75, 95% CI: 1.16–2.63; >14 years: aOR = 1.87, 95% CI: 1.19–2.96), and higher resilience (aOR = 1.02, 95% CI: 1.00–1.04). Conclusion WLWH living in the GTA had lower rates of viral suppression compared to the rest of Ontario and Canada even after adjustment of age, ethnicity, and HIV diagnosis duration. High-impact programming for WLWH in the GTA to improve HIV outcomes are greatly needed.

Funder

Canadian Institutes of Health Research

Canadian HIV Trials Network, Canadian Institutes of Health Research

Publisher

SAGE Publications

Subject

Infectious Diseases,Pharmacology (medical),Public Health, Environmental and Occupational Health,Dermatology

Link

http://journals.sagepub.com/doi/pdf/10.1177/09564624221108034

Reference45 articles.

1. Paris Declaration. Fast-track cities: ending the AIDS epidemic. Available at: https://www.iapac.org/files/2018/07/Fast-Track-Cities-Paris-Declaration_01DEC14.pdf (2014, accessed 9 April 2020).

2. United Nations General Assembly. Political declaration on HIV and AIDS: On the fast track to accelerating the fight against HIV and to ending the AIDS epidemic by 2030. Available at: https://www.unaids.org/sites/default/files/media_asset/2016-political-declaration-HIV-AIDS_en.pdf (2016, accessed 7 July 2020).

3. UNAIDS. 90-90-90 an ambitious treatment target to help end the AIDS epidemic. Available at: https://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf (2014, accessed 20 June 2020).

4. UNAIDS. Cities ending the AIDS pandemic. Available at: https://www.iapac.org/files/2018/07/cities-report-16JUN16.pdf (2016, accessed 11 April 2020).

5. Toronto to Zero. The future of HIV care in Toronto. Available at: https://torontotozero.ca/resources/ (2019, accessed 7 March 2020).

Cited by 3 articles. 订阅此论文施引文献订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献

1. Operationalizing the Women-Centred HIV Care Model for trans women and persons with transfeminine experience living with and affected by HIV: a qualitative study;International Journal of Transgender Health;2024-03-14

2. Challenges and barriers to HIV care engagement and care cascade: viewpoint;Frontiers in Reproductive Health;2023-07-20

3. Co-Creating Socio-Culturally-Appropriate Virtual Geriatric Care for Older Adults Living With HIV: A Community-Based Participatory, Intersectional Protocol;International Journal of Qualitative Methods;2023-01