# Influence of patient-centered HIV care on retention and viral suppression disparities

> **NIH NIH R01** · FLORIDA INTERNATIONAL UNIVERSITY · 2021 · $269,627

## Abstract

PROJECT SUMMARY
Achieving high rates of retention in human immunodeficiency (HIV) care and viral suppression through
antiretroviral therapy not only reduces mortality, but also is a means to reduce the incidence of HIV in affected
communities because viral suppression greatly decreases communicability and prevents the transmission of
resistant strains of the virus. Retention in care and viral suppression have been particularly challenging for
minority populations leading to racial and ethnic disparities in HIV outcomes, including survival. Among people
living with HIV infection in 2013, the percentage that was virally suppressed was only 51.5% among African
Americans, 58.2% among Latinos, and 65.0% among whites. Our central hypothesis is that provider patient-
centered care (PCC) factors interacting with dynamic patient psychosocial factors as well as neighborhood
social determinants and medical case management site factors are influencing retention in care and viral
suppression and thus contributing to health disparities. The objective of this application is to identify provider
PCC factors that are moderating the effect of changes in individual characteristics on retention in care and viral
suppression while considering neighborhood social determinants and medical case management site factors
and to predict to what extent changes in PCC factors could improve HIV care retention and viral suppression
and thus reduce health disparities. We will accomplish these objectives with a cohort study of people enrolled
in the Miami-Dade County Ryan White Program 2019–2021. The Ryan White Program serves 52% of people
living with HIV in the United States, in particular the medically underserved. To test our central hypothesis and
achieve the objectives of this application, we propose the following four specific aims: 1) Using causal
Bayesian networks, assess the moderating role of HIV provider PCC factors on the association between
patient-level characteristics and retention in HIV care, viral suppression, and related health disparities cross-
sectionally while accounting for neighborhood-level and medical case management site factors; 2) By means
of dynamic causal Bayesian networks, assess the moderating role of HIV provider PCC factors on the
association between longitudinal changes in patient-level characteristics and changes in retention in HIV care,
viral suppression, and related health disparities; 3) Using dynamic causal Bayesian networks, estimate the
magnitude of the expected improvement in retention in HIV care, viral suppression, and related health
disparities, produced by changing provider PCC factors; and 4) Identify feasibility and acceptability issues
related to potential interventions to address the most influential health disparities factors identified in aims 1–3
using expert interviews and focus group discussions with RWP providers, administrators, and patients. This
research thus supports one of the Trans-NIH Plan for HIV-Related Research...

## Key facts

- **NIH application ID:** 10058773
- **Project number:** 5R01MD012421-03
- **Recipient organization:** FLORIDA INTERNATIONAL UNIVERSITY
- **Principal Investigator:** MARY JO TREPKA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $269,627
- **Award type:** 5
- **Project period:** 2019-01-29 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10058773

## Citation

> US National Institutes of Health, RePORTER application 10058773, Influence of patient-centered HIV care on retention and viral suppression disparities (5R01MD012421-03). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10058773. Licensed CC0.

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