Harnessing registry data to identify socio-demographic and socio-economic gaps in HIV care in the Netherlands

Vita W. Jongen (), Anders Boyd, Thijs Albers, Nina Schat, Mark Verhagen, Rosan van Zoest, Marcel van den Berge, Cees van Nieuwkoop, Vanessa C. Harris, Wouter Bierman, Ard van Sighem and Marc van der Valk
Additional contact information
Vita W. Jongen: Stichting hiv monitoring
Anders Boyd: Stichting hiv monitoring
Thijs Albers: Hiv Vereniging
Nina Schat: Amsterdam Health & Technology Institute
Mark Verhagen: Amsterdam Health & Technology Institute
Rosan van Zoest: Amsterdam Health & Technology Institute
Marcel van den Berge: Admiraal de Ruyter Ziekenhuis, Department of Internal Medicine
Cees van Nieuwkoop: Haga Teaching Hospital
Vanessa C. Harris: Amsterdam Infection & Immunity Institute, Amsterdam University Medical Center, University of Amsterdam, Department of Infectious Diseases
Wouter Bierman: University of Groningen, Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Groningen
Ard van Sighem: Stichting hiv monitoring
Marc van der Valk: Stichting hiv monitoring

Nature Communications, 2025, vol. 16, issue 1, 1-8

Abstract: Abstract To ensure progress towards zero new HIV infections, more detailed information is needed about why certain individuals might not successfully transition through the steps of the HIV care continuum. We used data from 21,788 individuals with HIV who were enrolled in the ATHENA cohort before 31 December 2023, and combined these with registry data from Statistics Netherlands. This allowed modeling socio-demographic, -economic, and health-related determinants of not achieving two milestones of the HIV care continuum, i.e., suppressed viral load and engagement in care. Across all subgroups of men who have sex with men (MSM), cisgender heterosexual men, and women, living in poverty was associated with having detectable viral loads and disengagement from care, and younger age with only detectable viral loads. In MSM, having only primary education, a second-generation migration background, and living in a single-parent, institutionalized, or other household was also associated with having a detectable viral load. The HIV care continuum in the Netherlands is heavily influenced by socio-economic, rather than health-related, determinants. Efforts to optimize HIV care through specialized interventions should consider individual economic vulnerability. Our findings also illustrate the value of using registry data to identify gaps in care.

Date: 2025
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DOI: 10.1038/s41467-025-65512-6

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