Prevalence of Social Determinants of Health Risk Factors Among and Their Impact on Viral Suppression, Consistent Visits, and No-Show Rates Among Persons with HIV Who Identify as Hispanic

Abstract

The current study examines the association between language preference, social determinants of health (SDOH) risk factors, viral load, and HIV care outcomes among individuals of Hispanic ethnicity in the United States. More than half (54%) of all participants reported having two or more unmet needs. Hispanic individuals were more likely to be at risk in 2 or more domains than their non-Hispanic counterparts. Food insecurity was the most common risk factor reported and when present, 51% of patients also reported financial resource strain. Surprisingly, when language preference was analyzed, English-preferring Hispanic patients were at higher risk of financial resource strain, daily stress, and food insecurity compared to those who preferred Spanish. When accounting for birthplace, Hispanic patients born in the US reported higher rates of daily stress, food insecurity, and unavailable transportation compared to Hispanic patients born in Puerto Rico or elsewhere outside the US. Increased SDOH risk factors including financial resource strain, housing and utilities strain, and limited transportation access were significantly associated with higher rates of no-shows to HIV clinic appointments but not with increased viral load or consistent completed clinic visits. In a mixed-effects model, each additional at-risk domain correlated to a 0.198 increase in the no show rate. This model also demonstrates higher rates of no-show visits in English-preferring Hispanic patients compared to Spanish-preferring patients. Overall, SDOH risk factors were commonly reported in our population and their presence were associated with higher no-show rates but not with viral suppression.