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

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.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1038/s41467-025-65512-6

Authors

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Role:
Author
ORCID:
0000-0001-9538-1501
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Institution:
University of Oxford
Role:
Author


Publisher:
Nature Research
Journal:
Nature Communications More from this journal
Volume:
16
Issue:
1
Article number:
10517
Publication date:
2025-11-26
Acceptance date:
2025-10-14
DOI:
EISSN:
2041-1723
ISSN:
2041-1723


Language:
English
Pubs id:
2350341
UUID:
uuid_a5b29546-9707-4a84-bb2c-d5a9599a5eef
Local pid:
pubs:2350341
Source identifiers:
3509559
Deposit date:
2025-11-26
ARK identifier:
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