Associations of Routinely Collected Measures of Socioeconomic Disadvantage With Longitudinal Care Continuum Outcomes in a Clinical Cohort of Persons With HIV in the United States.

Objectives. To examine the associations of routinely collected measures of socioeconomic disadvantage with HIV care continuum outcomes in 2024. Methods. In a cohort of people with HIV in Baltimore, Maryland, we compared restricted mean time spent in 4 states of the longitudinal care continuum (viral suppression, nonsuppression, having a 12-month gap in viral load monitoring, and death) by income, housing status, incarceration, insurance, and neighborhood deprivation. Results. All measures of socioeconomic disadvantage were associated with fewer days spent alive and more days with a nonsuppressed viral load. Individual income and neighborhood deprivation were independently associated with survival and viral suppression: among participants in low-deprivation neighborhoods, those with lower income spent 7 more days with a nonsuppressed viral load (95% confidence interval [CI] = 0, 16) and 2 fewer days alive (95% CI = 0, 4); among participants with higher income, those living in higher-deprivation neighborhoods spent 14 more days with a nonsuppressed viral load (95% CI = 4, 24) and 2 fewer days alive (95% CI = 0, 5). Conclusions. The routine collection of data on socioeconomic disadvantage can help assess risk of poor clinical outcomes among persons with HIV. (Am J Public Health. Published online ahead of print August 13, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308484).