Improving Estimation of HIV Viral Suppression in the United States: A Method to Adjust HIV Surveillance Estimates From the Medical Monitoring Project Using Cohort Data

Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos.

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Antiretroviral Prescription and Viral Suppression in a Representative Sample of HIV-Infected Persons in Care in 4 Large Metropolitan Areas of the United States, Medical Monitoring Project, 2011–2013

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001482 ◽

2017 ◽

Vol 76 (2) ◽

pp. 158-170 ◽

Cited By ~ 5

Author(s):

Amy Rock Wohl ◽

Nanette Benbow ◽

Judith Tejero ◽

Christopher Johnson ◽

Susan Scheer ◽

...

Keyword(s):

United States ◽

Representative Sample ◽

Viral Suppression ◽

Metropolitan Areas ◽

The United States ◽

Medical Monitoring ◽

Medical Monitoring Project

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A Matter of Perspective: Comparison of the Characteristics of Persons with HIV Infection in the United States from the HIV Outpatient Study, Medical Monitoring Project, and National HIV Surveillance System

The Open AIDS Journal ◽

10.2174/1874613601509010123 ◽

2015 ◽

Vol 9 (1) ◽

pp. 123-133 ◽

Cited By ~ 13

Author(s):

Kate Buchacz ◽

Emma L. Frazier ◽

H. Irene Hall ◽

Rachel Hart ◽

Ping Huang ◽

...

Keyword(s):

United States ◽

Hiv Infection ◽

Surveillance System ◽

The United States ◽

Hiv Care ◽

Medical Monitoring ◽

Hiv Surveillance ◽

The Us ◽

Medical Monitoring Project ◽

Outpatient Study

Comparative analyses of the characteristics of persons living with HIV infection (PLWH) in the United States (US) captured in surveillance and other observational databases are few. To explore potential joint data use to guide HIV treatment and prevention in the US, we examined three CDC-funded data sources in 2012: the HIV Outpatient Study (HOPS), a multisite longitudinal cohort; the Medical Monitoring Project (MMP), a probability sample of PLWH receiving medical care; and the National HIV Surveillance System (NHSS), a surveillance system of all PLWH. Overall, data from 1,697 HOPS, 4,901 MMP, and 865,102 NHSS PLWH were analyzed. Compared with the MMP population, HOPS participants were more likely to be older, non-Hispanic/Latino white, not using injection drugs, insured, diagnosed with HIV before 2009, prescribed antiretroviral therapy, and to have most recent CD4+ T-lymphocyte cell count ≥500 cells/mm3 and most recent viral load test<2 00 copies/mL. The MMP population was demographically similar to all PLWH in NHSS, except it tended to be slightly older, HIV diagnosed more recently, and to have AIDS. Our comparative results provide an essential first step for combined epidemiologic data analyses to inform HIV care and prevention for PLWH in the US.

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A National Behavioral and Clinical Surveillance System of Adults With Diagnosed HIV (The Medical Monitoring Project): Protocol for an Annual Cross-Sectional Interview and Medical Record Abstraction Survey

JMIR Research Protocols ◽

10.2196/15453 ◽

2019 ◽

Vol 8 (11) ◽

pp. e15453 ◽

Cited By ~ 6

Author(s):

Linda Beer ◽

Christopher H Johnson ◽

Jennifer L Fagan ◽

Emma L Frazier ◽

Margaret Nyaku ◽

...

Keyword(s):

United States ◽

Medical Record ◽

Surveillance System ◽

Hiv Transmission ◽

The United States ◽

Population Based ◽

Medical Monitoring ◽

Hiv Surveillance ◽

Clinical Surveillance ◽

Medical Monitoring Project

Background The Medical Monitoring Project (MMP) is a national population-based behavioral and clinical surveillance system of adults with diagnosed HIV in the United States, and it is sponsored by the Centers for Disease Control and Prevention (CDC). Its purpose is to provide locally and nationally representative estimates of factors affecting HIV transmission risk and clinical outcomes. Objective This study aimed to describe the rationale for and methodology of the MMP, in addition to its contribution to evaluating and monitoring HIV prevention, care, and treatment efforts in the United States. Methods MMP employs a stratified 2-stage sample design to select annual samples of persons living with diagnosed HIV from the National HIV Surveillance System and conducts interviews and medical record abstractions with participating persons. Results MMP data are published routinely via annual reports, conference presentations, and scientific publications. Data may be accessed upon request from the CDC, contingent on the guidelines established for the security and confidentiality of HIV surveillance data. Conclusions MMP is the only source of annual population-based data on the behaviors and clinical care of persons with diagnosed HIV in the United States. It provides essential information for monitoring progress toward national treatment and prevention goals and guiding efforts to improve the health of persons with diagnosed HIV and prevent HIV transmission. International Registered Report Identifier (IRRID) RR1-10.2196/15453

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