Latent Class Analysis of Syndemic Factors Associated with Sustained Viral Suppression among Ryan White HIV/AIDS Program Clients in Miami, 2017

The study’s objective was to identify the association between sustained viral suppression (all viral load tests < 200 copies/ml per year) and patterns of co-occurring risk factors including, mental health, substance use, sexual risk behavior, and adverse social conditions for people with HIV (PWH). Latent class analysis followed by multivariable logistic regression was conducted for 6554 PWH in the Miami-Dade County Ryan White Program during 2017, and a five-class model was selected. Compared to Class 1 (no risk factors), the odds of achieving sustained viral suppression was significantly lower for Class 2 (mental health) (aOR: 0.67; 95% CI 0.54–0.83), Class 3 (substance use and multiple sexual partners) (0.60; 0.47–0.76), Class 4 (substance use, multiple sexual partners, and domestic violence) (0.71; 0.55–0.93), and Class 5 (mental health, substance use, multiple sexual partners, domestic violence, and homelessness) (0.26; 0.19–0.35). Findings indicate the need for targeted interventions that address these syndemic factors.