Work

Outcomes Along the HIV Care Continuum Among Undocumented Immigrants in Clinical Care

Year: 2017

Type: article

Abstract: HIV-infected undocumented immigrants face unique barriers to care yet little is known about their clinical outcomes. We performed a retrospective cohort study of HIV-infected adults in clinical care from 2006 to 2014 at a large academic medical center in a setting where medical insurance is available to HIV-infected undocumented immigrants. Undocumented status was assessed based on Social Security number and insurance status and verified through medical chart review. Using Poisson regression models, we compared undocumented and documented patients with respect to retention in care (≥2 HIV-related laboratory tests ≥90 days apart), antiretroviral therapy (ART) prescription (≥3 active antiretroviral agents prescribed in a year), and viral suppression (HIV RNA <200 copies/ml for the last measured viral load) for each year in care. Of 7,551 patients included in the analysis, we classified 173 (2.3%) as undocumented. For each year of the analysis, higher proportions of undocumented patients were retained in care, prescribed ART, and virally suppressed. In adjusted models, undocumented status was associated with increased probability of retention in care [risk ratio (RR) 1.05, confidence interval (95% CI) 1.01-1.09], ART prescription (RR 1.05, 95% CI 1.01-1.08), and viral suppression (RR 1.13, 95% CI 1.08-1.19) compared to documented status. Undocumented patients achieved clinical outcomes at modestly higher rates than documented patients, despite entering care with more advanced disease. In a setting where insurance is available to undocumented patients, similar outcomes along the HIV care continuum may be achieved regardless of immigration status.

Source: AIDS Research and Human Retroviruses

DOI: 10.1089/aid.2017.0015

Authors: Jonathan Ross, Uriel R. Felsen, Chinazo O. Cunningham, Viraj V. Patel, David B. Hanna

Institutions: Montefiore Medical Center, Montefiore Health System, Albert Einstein College of Medicine

Language: English

Topic: HIV/AIDS Research and Interventions

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: green

Funders: National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Institute on Minority Health and Health Disparities