Association Between County-Level Social Vulnerability and Centers for Disease Control and Prevention-Funded HIV
Wei Song1, Mesfin S Mulatu, Nicole Crepaz
1Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Journal of Acquired Immune Deficiency Syndromes (1999)
|January 9, 2025
Summary
Community-level social vulnerability impacts HIV testing outcomes. While CDC-funded programs reach vulnerable areas, disparities in HIV positivity, care linkage, and prevention referrals persist, requiring targeted resource allocation.
Area of Science:
- Public Health
- Epidemiology
- Social Determinants of Health
Background:
- Community-level social vulnerabilities significantly influence HIV outcomes.
- This study examined the association between county-level social vulnerability and HIV testing program results funded by the Centers for Disease Control and Prevention (CDC).
Purpose of the Study:
- To assess the relationship between county-level social vulnerability and key performance indicators of CDC-funded HIV testing programs.
- To identify disparities in HIV testing outcomes based on social vulnerability metrics.
Main Methods:
- Utilized HIV testing data from 60 state/local health departments and 119 community-based organizations (2020-2022).
- Integrated HIV testing data with the Minority Health Social Vulnerability Index (SVI) at the county level.
- Calculated disparity measures for HIV positivity, linkage to care, partner services, and pre-exposure prophylaxis (PrEP) referrals between high and low SVI counties.
Main Results:
- Over 85% of 4.9 million HIV tests occurred in high social vulnerability counties.
- Higher HIV positivity (1.1%) and linkage to care (77.5%) were observed in high SVI counties.
- Lower rates of partner services (72.1%) and PrEP referrals (48.1%) were found in high SVI counties, with disparities varying by demographics and site type.
Conclusions:
- CDC-funded HIV testing programs effectively reach vulnerable populations.
- HIV testing program outcomes, including linkage and prevention referrals, demonstrate variability influenced by social vulnerability, demographics, and testing site.
- Ongoing monitoring of social vulnerability's impact on HIV testing is crucial for resource allocation and ending the HIV epidemic.
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