All ETDs from UAB

Authors

Maira Sohail

Advisory Committee Chair

Emily B Levitan

Advisory Committee Members

D Scott Batey

Dustin Long

Michael Mugavero

Akinyemi I Ojesina

Document Type

Dissertation

Date of Award

2021

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

A supportive intimate partner has shown to be helpful in HIV care of men who have sex with men, and in some African heterosexual couples; however, knowledge on this phenomenon among heterosexual people with HIV (PWH) is limited in the United States context. This project included two quantitative studies and one qualitative study to examine the role of intimate partnership in HIV care among heterosexual, newly diagnosed PWH. Both quantitative studies were conducted among heterosexual, newly diagnosed (2013-2017) individuals at the University of Alabama at Birmingham (UAB) 1917 Clinic. The first study examined the role of partnership (un-partnered, unmarried-partnered, and married) on HIV retention in care by measuring visit constancy [individuals attending ≥1 primary care provider visit in four 6-month intervals were considered to have high visit constancy] and no-shows [categorized as ≥1 missed visit vs. 0 missed visit]. The second study assessed the role of partnership on time to viral suppression (TVS) [time to first viral load <200 copies/ml] and sustained viral suppression (SVS) [individuals with consecutive suppressed viral loads after first viral suppression]. TVS was examined by calculating hazard ratios (HR) and 95% confidence intervals (CI). Visit constancy, no-shows, and SVS were examined by calculating odds ratios (OR) and 95% CIs. All models were controlled for confounders. The third, qualitative study explored the role of partnership on HIV care around the time of and iv following HIV diagnosis of newly diagnosed (≥2017), heterosexual individuals, recruited from six HIV clinics/organizations in Alabama. Compared to un-partnered, married individuals had ~3x higher odds of visit constancy [OR (95% CI): 2.93 (1.04, 8.30)] and 69% higher hazard of TVS [HR (95% CI): 1.69 (1.02, 2.78)]; no differences were observed for no-shows and SVS. Un-partnered and unmarried-partnered individuals performed similarly on all measures. The qualitative findings showed good-quality partnership to play an important role in HIV care of PWH. The importance of partnership in HIV care was also acknowledged by un-partnered individuals, highlighting the influence of the quality of partnership. Combined findings from this study imply being married or having a good-quality partnership may have a positive impact on HIV health outcomes of PWH.

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