High viral suppression amid demographic disparities: a U.S. national cohort of people with HIV on a popular dating app.

Abstract

Objective: We sought to determine the prevalence and examine demographic disparities of viral suppression (VS, <200 copies/mL) and awareness of VS status among people with HIV (PWH) on a popular geosocial networking/dating application (GSN-app).

Design: Cross-sectional, observational study.

Methods: U.S. adult PWH were remotely-recruited through a GSN-app to complete a survey from January-September 2024. We assessed the prevalence and correlates of self-reported awareness of VS status and VS using modified Poisson regression with the following variables: demographics, substance use, region, and Ending-the-HIV-Epidemic priority jurisdiction. Laboratory-based viral loads were collected from a sub-sample of the cohort, allowing comparison of laboratory-based VS to self-reported VS.

Results: Among 2,838 geographically diverse participants, 28% were Black, 32% aged 18-34 years, and 36% reported stimulant use. Overall, 94.9% reported knowing their VS status. Younger, Black, and stimulant-using PWH were less likely to know their VS status. When VS status was known, 93.5% reported VS. Younger and stimulant-using PWH were less likely to report VS. Of the sub-sample with laboratory verification (n = 923), 91.6% who self-reported VS demonstrated laboratory-confirmed VS.

Conclusion: This remotely-recruited U.S. national survey showed high self-reported VS among PWH on a popular GSN-app, in high concordance with laboratory-confirmed VS in a sub-sample. Stimulant use was reported by over one-third of participants, with lower reported VS in this group. Inequities in awareness of VS status among younger, Black, and stimulant-using PWH and lower VS among younger and stimulant-using PWH should be ameliorated through targeted care reengagement and adherence interventions, potentially via GSN-apps.