4.4 Article

Interstate Mobility of People With Diagnosed HIV in the United States, 2011-2019

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PUBLIC HEALTH REPORTS
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SAGE PUBLICATIONS INC
DOI: 10.1177/00333549231208488

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HIV; mobility; migration; United States

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Assessing mobility among people with HIV is vital for understanding HIV incidence, prevalence, and care continuum in the US. This study found higher migration rates among people with HIV compared to the general population, with factors such as age, sex, and transmission category influencing migration. HIV-positive individuals who migrated were more likely to receive medical care and achieve viral suppression.
Objective: Assessing mobility among people with HIV is an important consideration when measuring HIV incidence, prevalence, and the care continuum in the United States. Our aims were to measure mobility among people with HIV compared with the general population and to examine factors associated with migration among people with HIV. Methods: We calculated state-to-state move-in and move-out migration rates for 2011 through 2019 using National HIV Surveillance System data for people with HIV and using US Census data for the general population. For people with HIV, we also assessed the association between migration and HIV care outcomes. Results: From 2011 through 2019, the US general population had stable migration, whereas migration rates among people with HIV fluctuated and were higher than among the general population. Among people with HIV, migration rates in 2019 were higher among people assigned male sex at birth versus female sex at birth, among people aged <= 24 years versus >= 25 years, among people with HIV infection attributed to male-to-male sexual contact versus other transmission categories, and among non-Hispanic Other people (ie, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, or multiple races) versus Hispanic, non-Hispanic Black, and non-Hispanic White people. Receipt of HIV medical care (90.3% vs 75.5%) and achieving viral suppression (72.1% vs 65.3%) were higher among people with HIV who migrated versus those who did not. Conclusions: People with HIV in the United States are more mobile than the general population. Determining the mobility of people with HIV can help with strategic allocation of HIV prevention and care resources.

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