Date of Conferral

2023

Degree

Doctor of Public Health (DrPH)

School

Health Services

Advisor

Stacy-Ann Christian

Abstract

Viral suppression within human immunodeficiency virus (HIV) care and treatment planning is the gold standard of care for most providers when engaging with their patients. In many settings, the patient has received a positive lab that is indicative of HIV antibodies being detected; this in turn means they need additional medical attention to manage the infection. Upon receiving linkage to care services and attending an initial appointment, an initial genetic sequence is usually completed to assess the patient’s strain of HIV and how antiretroviral medications may antagonize or complement the HIV strain. It is possible that access, bias, and colorism played a role in the administration of genetic sequencing practices. The initial research questions aimed at reviewing zip codes to determine if there are racial differences in terms of achieving suppression and being sequenced. Logistic regression results showed no correlation between the zip codes and viral suppression and genetic sequence. However, the race and gender of newly diagnosed persons with HIV differed by zip code. The results also revealed that genetic material was sampled in White patients more often than in people of color. That genetic sequencing is being skipped is problematic when patients may not receive the right combination of medications at the start of their chronic management of HIV. Such practices prevent progress in getting to zero new infections.

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