Identifying Factors Associated With HIV Viral Suppression and Health Care Outcomes in the Florida Cohort Study Wave 3: Protocol for a Prospective Cohort Study.

Abstract

Background: Ending the HIV epidemic remains a high public health priority, and the state of Florida continues to have high HIV prevalence and incidence.

Objective: This protocol aims to identify factors associated with the HIV care continuum and HIV-related comorbidities, with a focus on the impacts of alcohol use.

Methods: The Florida Cohort study wave 3 enrolled people with HIV aged 18 years or older from 9 clinical, case management, and community settings across Florida from 2020 to 2023. All participants completed a baseline questionnaire, and most (769/836, 92%) completed additional questionnaires at baseline and/or approximately 1 year after baseline. Data on HIV care and treatment, mental health, substance use, stigma, and technology were collected in the baseline questionnaire. Additional questionnaires covered alcohol use, gender identity, pet ownership, stigma and discrimination, antiretroviral therapy preferences, and the impacts of the COVID-19 pandemic. Questionnaire data were securely linked to HIV care continuum variables from Florida's state HIV monitoring system.

Results: Overall, the study enrolled 836 people with HIV. Among them, 397 (47.5%) were non-Hispanic Black, 131 (15.7%) were Hispanic, 505 (60.4%) were assigned male sex at birth, and 487 (58.3%) were aged above 50 years. Most (n=769, 92%) participants were linked to the state HIV reporting system and will be followed for up to 5 years to monitor HIV outcomes. A total of 31 (94% of 33 eligible) participants completed the gender identity questionnaire, 230 (91.3% of 252 eligible) completed the alcohol questionnaire, 287 (91.7% of 313 eligible) completed the COVID-19 questionnaire, 221 (85% of 260 eligible) completed the pet questionnaire, 461 (87.6% of 526 eligible) completed the stigma and discrimination questionnaire, and 210 (85.7% of 245 eligible) completed the antiretroviral therapy preference questionnaire.

Conclusions: This study provides opportunities to monitor changes in HIV-related outcomes as well as relevant attitudes, behaviors, and health care preferences; however, it has some limitations in terms of representativeness and tracking longitudinal outcomes.

International registered report identifier (irrid): DERR1-10.2196/69702.