Development and Validation of Vulnerable and Enabling Indices for HIV Viral Suppression among People with HIV Enrolled in the Ryan White Program

Merhawi T. Gebrezgi, Mary Jo Trepka, Semiu O. Gbadamosi, Kristopher P. Fennie, Daisy Ramirez-Ortiz, Tan Li, Sofia B. Fernandez, Petra Brock, Robert A. Ladner and Diana M. Sheehan
Additional contact information
Merhawi T. Gebrezgi: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA
Mary Jo Trepka: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA
Semiu O. Gbadamosi: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA
Kristopher P. Fennie: Division of Natural Sciences, New College of Florida, 5800 Bayshore Rd, Sarasota, FL 34243, USA
Daisy Ramirez-Ortiz: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA
Tan Li: Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA
Sofia B. Fernandez: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA
Petra Brock: Behavioral Science Research Corporation, 2121 Ponce de Leon Blvd, Coral Gables, FL 33134, USA
Robert A. Ladner: Behavioral Science Research Corporation, 2121 Ponce de Leon Blvd, Coral Gables, FL 33134, USA
Diana M. Sheehan: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA

IJERPH, 2021, vol. 18, issue 13, 1-11

Abstract: Background: Numerous factors impact HIV care, often requiring consideration of indices to prevent collinearity when using statistical modeling. Using the Behavioral Model for Vulnerable Populations, we developed vulnerable and enabling indices for people living with HIV (PLWH). Methods: We used Ryan White Program (RWP) data and principal component analysis to develop general and gender- and racial/ethnic-specific indices. We assessed internal reliability (Cronbach’s alpha), convergent validity (correlation coefficient), and predictive utility (logistic regression) with non-viral suppression. Results: Three general factors accounting for 79.2% of indicators’ variability surfaced: mental health, drug use, and socioeconomic status (Cronbach’s alpha 0.68). Among the overall RWP population, indices showed convergent validity and predictive utility. Using gender- or racial/ethnic-specific indices did not improve psychometric performance. Discussion: General mental health, drug use, and socioeconomic indices using administrative data showed acceptable reliability, validity, and utility for non-viral suppression in an overall PLWH population and in gender- and racial/ethnic-stratified populations. These general indices may be used with similar validity and utility across gender and racial/ethnic diverse populations.

Keywords: HIV; vulnerable factors; enabling factors; Behavioral Model for Vulnerable Populations; psychometric properties (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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