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

> **NIH NIH R01** · FLORIDA INTERNATIONAL UNIVERSITY · 2020 · $163,916

## Abstract

Abstract
Antiretroviral therapy leads to viral suppression which not only prevents the progression of human
immunodeficiency virus (HIV) infection to acquired immunodeficiency syndrome and death among people living
with HIV (PLH), but also prevents the transmission of HIV. Therefore, viral suppression is one of the key
indicators in the National HIV/AIDS Strategy for the United States. On March 12, 2020, the Mayor of Miami-
Dade County declared a State of Emergency in the County due to the COVID-19 Public Health Emergency
(PHE) and on March 25, 2020 advised all people 65 and older and those with health conditions, including
immunosuppression, to stay home. These and other necessary steps to combat COVID-19 had a far-reaching
impact on HIV care; most HIV medical case management sites and HIV clinicians began delivering care via
telehealth or telephone, reducing the availability of in-person services. Furthermore, the ripple effects due to
the loss of the tourist industry and closure of nonessential businesses have led to widespread unemployment
and economic hardship within the community with 67,000 unemployment claims as of April 21st. The Ryan
White Program (RWP) serves about 52% of PLH in the United States and is the provider of last resort, serving
uninsured and underinsured PLH. Thus, the RWP serves among the most socioeconomically vulnerable PLH.
Anecdotal reports indicate that many PLH are struggling with the COVID-19 PHE-related changes in HIV care
delivery and are experiencing significant hardships such as food insecurity. The objective of this study is to
characterize the COVID-19 PHE-related changes in HIV care delivery (e.g. use of telehealth and other remote
modes of delivery) and any related difficulties and the COVID-19 PHE-related socioeconomic and psychosocial
hardships experienced by RWP clients and assess how these have affected HIV viral suppression among
RWP clients. A further objective is to compare the effects by racial/ethnic and gender groups to identify any
potential inequities. To accomplish these objectives, we will interview 300 RWP clients by telephone (130
Hispanic, 100 African American, and 70 Haitians with roughly half men and half women in each group) about
their HIV care and COVID-19 PHE-related socioeconomic and psychosocial stressors and compare their HIV
viral loads before and after the onset of the COVID-19 PHE. This study will provide important information about
how the COVID-19 PHE is impacting viral suppression among RWP clients, and the extent to which COVID-19
PHE-related stressors are novel barriers to care. Any inequitable impacts by race/ethnicity and gender will also
be examined. This information is also critical, because due to the immune suppression experienced by many
PLH, it is likely that social distancing measures may be needed during HIV care delivery for an extended
period of time during the current pandemic.

## Key facts

- **NIH application ID:** 10156759
- **Project number:** 3R01MD012421-02S1
- **Recipient organization:** FLORIDA INTERNATIONAL UNIVERSITY
- **Principal Investigator:** MARY JO TREPKA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $163,916
- **Award type:** 3
- **Project period:** 2019-01-29 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10156759

## Citation

> US National Institutes of Health, RePORTER application 10156759, Influence of patient-centered HIV care on retention and viral suppression disparities (3R01MD012421-02S1). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10156759. Licensed CC0.

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