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Databases

Ryan White - Clinic, HIV, Environmental, and Implementation Outcomes 2023

Aggregated database of 105 Ryan White clinics pulled from 8 public but disparate databases related to clinic metrics as well as their region (split across HIV-related metrics, environment-metrics, and implementation outcomes). Data sourced between August 2022-March 2023 from:

  • www.data.census.gov
  • www.namecensus.com
  • www.data.hrsa.gov
  • www.kff.org
  • www.hivlawandpolicy.org
  • www.aidsvu.org
  • www.countyhealthrankings.org
  • www.gis.cdc.gov

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Tables

Implementation Outcome Variables

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(Mean (SD) or % (SD), and % Missing)

(n=104) Missing, %
Testing
Ever tested for HIV (cnty), 2016-17 (%) 47.1 (7.5) 10.6
Tested for HIV, 2016-2017 (cnty), (%) 15.7 (4.6) 10.6
Knowledge of status (state), 2019 80425.7 (50305.9) 0
Linked to Care
Incident HIV - linked to care (state), 2019 2233.4 (1372.9) 0
Incident HIV - linked to care (cnty), 2020 (%) 83.7 (3.3) 10.6
Receiving Care
Receiving care (state), 2019 59407.9 (38134.8) 0
Receiving care (cnty), 2020 (%) 71.6 (2.1) 10.6
Viral Suppression
Virally suppressed (state), 2019 51543.2 (34035.3) 0
Virally suppressed (cnty), 2020 (%) 61.7 (2.1) 10.6
PrEP
Prescribed PrEP (state), 2019 25016.7 (16323.1) 0
PrEP use (cnty), 2020 (%) 0.2 (0.1) 10.6
PrEP users female (cnty), 2020 (%) 6.6 (3.3) 10.6
PrEP users male (cnty), 2020 (%) 93.3 (3.3) 10.6
PrEP users 13-24 (cnty), 2020 (%) 10.4 (2.1) 10.6
PrEP users 25-34 (cnty), 2020 (%) 41.1 (1.9) 10.6
PrEP users 35-44 (cnty), 2020 (%) 26.6 (2.3) 10.6
PrEP users 45-54 (cnty), 2020 (%) 13.1 (1.2) 10.6
PrEP users >55 (cnty), 2020 (%) 8.8 (0.9) 10.6
PrEP Use to HIV Incidence
Ratio of 2021 PrEP users to 2020 HIV incidence (cnty), 2020 12.9 (4.4) 10.6
Ratio of 2021 female PrEP users to 2020 female HIV incidence (cnty), 2021 5.2 (1.3) 10.6
Ratio of 2021 male PrEP users to 2020 HIV incidence (cnty), 2021 14.1 (4.8) 10.6
Ratio of 2021 25-34 PrEP users to 2020 HIV incidence (cnty), 2020 13.7 (4.6) 10.6
Ratio of 2021 35-44 PrEP users to 2020 HIV incidence (cnty), 2020 17.6 (7.6) 10.6
Ratio of 2021 45-54 PrEP users to 2020 HIV incidence (cnty), 2020 13.9 (6.0) 10.6
Ratio of 2021 >54 PrEP users to 2020 HIV incidence (cnty), 2020 12.8 (5.1) 10.6
Mortality
HIV mortality rate (per 100K) (state), 2019a 6.6 (2.5) 0
Calculated HIV mortality rate (per 100K) (state), 2020a 6.4 (2.2) 0
AIDS mortality rate (per 100K) (state), 2019a 5.0 (1.8) 0

Values are means(SD) or medians(Q25, Q75) for continuous variables; percentages or ns or both for categorical variables.

a: Mortality among those who are HIV+ and with AIDS (respectively) and are not necessarily attibuted to HIV/AIDS-related causes.

Clinic Variables

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(Mean (SD) or % (SD), and % Missing)

(n=104) Missing, %
Patients
Clinic (clnc), 2021 54789.3 (55743.4) 68.3
Patient Age
<18 (clnc), 2021 (%) 26.4 (10.9) 70.2
18-64 (clnc), 2021 (%) 67.8 (12.6) 68.3
>64 (clnc), 2021 (%) 7.4 (2.3) 68.3
Patient Race / Ethnicity
Racial/ethnic minorities (clnc), 2021 (%) 83.7 (11.5) 68.3
Asian (clnc), 2021, (%) 3.8 (3.9) 68.3
Black (clnc), 2021 (%) 38.8 (29.5) 68.3
Hispanic (clnc), 2021 (%) 44.4 (26.7) 68.3
American Indian or Alaska Native (clnc), 2021 (%) 2.5 (8.6) 68.3
Native Hawaiian or Other (clnc), 2021 (%) 0.7 (0.7) 73.1
Multiracial (clnc), 2021 (%) 2.1 (2.2) 71.2
Prefer non-English services (clnc), 2021 (%) 24.8 (16.8) 68.3
Patient Conditions
HIV (clnc), 2021 (%) 3.6 (6.6) 68.3
Linked to care (clnc), 2021 (%) 89.7 (7.7) 89.4
Prenatal (clnc), 2021 1276.0 (1529.6) 70.2
Prenatal patients attended 1st tri visit (clnc), 2021 (%) 70.6 (12.2) 71.2
Prenatal deliveries (clnc), 2021 645.0 (757.8) 70.2
Babies delivered with low birth weight (clnc), 2021 (%) 7.1 (2.7) 79.8
Diabetic (clnc), 2021 (%) 15.7 (5.2) 68.3
Uncontrolled diabetics (clnc), 2021 (%) 37.7 (7.5) 68.3
Hypertensive (clnc), 2021 (%) 29.4 (10.2) 68.3
Hypertensive with uncontrolled BP (clnc), 2021 (%) 47.5 (7.0) 68.3
Depressed and in remission (clnc), 2021 (%) 15.1 (13.2) 74
Asthmatic (clnc), % 5.6 (2.9) 68.3
Patient Care
Receiving medical care (clnc), 2021 (%) 90.9 (5.8) 68.3
Receiving preventive statin therapy for CVD (clnc), 2021 (%) 72.9 (7.8) 68.3
Receiving dental care (clnc), 2021 (%) 15.1 (8.1) 70.2
Receiving dental sealants (clnc), 2021 (%) 53.3 (28.3) 80.8
Receiving mental health care (clnc), 2021 (%) 7.9 (6.2) 68.3
Receiving substance use services (clnc), 2021 (%) 1.5 (1.7) 72.1
Receiving eye care (clnc), 2021 (%) 2.8 (3.6) 76
Receiving support services (clnc), 2021 (%) 16.2 (18.1) 68.3
Ischemic Vascular Disease patients receiving Aspirin (clnc), 2021 (%) 77.6 (9.0) 68.3
Adults receiving weight screening (clnc), 2021 (%) 61.8 (22.9) 68.3
<18 receiving weight screening (clnc), 2021 (%) 62.5 (24.9) 68.3
Females receiving mammogram (clnc), 2021 (%) 42.6 (16.0) 68.3
Females receiving pap smear (clnc), 2021 (%) 51.2 (13.6) 68.3
Received colonoscopy (clnc), 2021 (%) 39.8 (15.9) 68.3
Received depression screening (clnc), 2021 (%) 67.3 (18.8) 68.3
Adults receiving tobacco screening services (clnc), 2021 (%) 80.7 (11.3) 68.3
Patient Financials
<100% Poverty Level (clnc), 2021 (%) 74.7 (15.3) 68.3
<200% Poverty Level (clnc), 2021 (%) 94.0 (9.2) 68.3
Medicare (clnc), 2021 (%) 6.5 (2.7) 68.3
Medicaid/CHIP (clnc), 2021 (%) 56.0 (16.5) 68.3
3rd party insurance (clnc), 2021 (%) 11.2 (9.6) 68.3
Uninsured (clnc), 2021 (%) 26.3 (15.1) 68.3
Clinic Financials
Total clinic operational costs in last year ($100K) (clnc), 2021 992.7 (1425.5) 68.3
Total yearly grant expenditures ($100K) (clnc), 2021 73.3 (39.0) 69.2
Clinic operational costs per patient ($) (clnc), 2021 1927.1 (1498.0) 68.3

Values are means(SD) or medians(Q25, Q75) for continuous variables; percentages or ns or both for categorical variables.

a: Missingness due to many clinics not being included in the HRSA database which contained the information on clinic-level variables.

Environmental Variables

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(Mean (SD) or % (SD), and % Missing)

(n=104) Missing, %
Population
Size (zipc), 2020 4930877.0 (3742123.0) 0
Female (zipc), 2020 (%) 51.1 (1.2) 1.9
Density (persons/mi2) (cnty), 2020 3464.4 (2366.2) 0
Rural / Urban Communities
Rural population (state), 2019 (%) 11.7 (10.3) 0
County community type (cnty), 2019 0
- Urban, % 100.0
Urbanicity level (cnty), 2020 9.6
- Large Urban, % 100.0
Age
<5 (zipc), 2020 (%) 5.7 (0.4) 1.9
<18 (zipc), 2020 (%) 21.5 (1.2) 1.9
18-65 (zipc), 2020 (%) 64.3 (5.2) 0
>65 (zipc), 2020 (%) 15.0 (1.0) 1.9
Race
Asian (zipc), 2020 (%) 9.7 (5.5) 1.9
White (zipc), 2020 (%) 61.9 (15.0) 1.9
Non-Hispanic White (zipc), 2020 (%) 35.6 (11.2) 1.9
Black (zipc), 2020 (%) 24.2 (20.4) 1.9
American Indian (zipc), 2020 (%) 1.0 (0.4) 1.9
Native Hawaiian or Pacific Islander (zipc), 2020 (%) 0.3 (0.2) 4.8
Hispanic (zipc), 2020 (%) 29.1 (17.4) 1.9
Multiracial (zipc), 2020 (%) 3.0 (0.9) 1.9
Family Dynamics
Mean family size (zipc), 2020 3.3 (0.5) 8.7
Have children (zipc), 2021 (%) 18.9 (7.6) 5.8
Median income of households with >1 child spent on childcare (cnty), 2020-21 (%) 28.2 (5.1) 0
Children living in single-parent household (cnty), 2016-20 (%) 31.0 (10.1) 0
Never married (zipc), 2020 (%) 49.6 (14.1) 5.8
Social associations membership rate (per 10K) (cnty), 2019 7.6 (2.2) 0
Teen births (per 1K females 15-19) (cnty), 2014-20 20.5 (7.0) 0
Income
Median county income ($) (zipc), 2020 37959.0 (3956.4) 1.9
Median household income ($) (cnty), 2020 70027.9 (11977.9) 0
Ratio of female to male median earnings for full-time workers (cnty), 2016-20 0.9 (0.1) 0
Ratio of 80th to 20th income percentile (cnty), 2016-20 5.4 (0.5) 1
Income inequality (GINI) coefficient (0.0-1.0) (cnty), 2020 0.5 (0.0) 10.6
Hourly wage needed for basic expenses and taxes for an adult and two children ($) (cnty), 2021 44.5 (5.4) 0
Poverty
Poverty (cnty), 2020 (%) 13.8 (3.5) 10.6
<18 and in poverty (cnty), 2020 (%) 18.3 (5.1) 0
Households below poverty level (state), 2019 (%) 10.8 (2.4) 0
Low-income and living far from grocery stores (cnty), 2019 (%) 3.0 (3.2) 0
Housing
Households with 1 or more housing problems (cnty), 2014-18 (%) 24.5 (5.7) 0
Housing-insecure (cnty), 2020 (%) 20.4 (2.9) 10.6
Houses that are owner-occupied (cnty), 2016-20 (%) 52.4 (6.3) 0
Households spending at least half of income on housing (cnty), 2016-20 (%) 19.9 (3.5) 0
Vacant housing (state), 2019 (%) 9.9 (4.3) 0
Employment
Employed (zipc), 2020 (%) 57.4 (10.7) 5.8
Mean work hours per week (zipc), 2020 38.0 (3.7) 5.8
Government workers (zipc), 2020 (%) 13.8 (5.3) 5.8
>16 unemployed and seeking work (cnty), 2020 (%) 10.3 (2.1) 0
16-19 not in school and unemployed (cnty), 2016-20 (%) 7.4 (2.0) 0
Education
Children in public schools eligible for free/reduced lunch (cnty), 2019-20 (%) 60.7 (7.5) 0
Enrolled in K-12 (zipc), 2020 (%) 55.6 (19.0) 5.8
9th grade cohort graduating in 4 years (cnty), 2018-19 (%) 83.3 (7.4) 22.1
>25 with HS diploma (cnty), 2016-20 (%) 85.0 (3.7) 0
>25 without HS diploma (state), 2019 (%) 15.2 (3.7) 0
Bachelors degree or higher (zipc), 2020 (%) 38.0 (22.4) 5.8
Mean 3rd grade reading test performance (0-10) (cnty), 2018 3.0 (0.1) 17.3
Mean 3rd grade math test performance (0-10) (cnty), 2018 2.8 (0.1) 17.3
Mean difference between actual and required public school spending per student ($) (cnty), 2019 -1647.7 (4868.5) 0
School racial segregation level relative to local distribution (0.0-1.0) (cnty), 2020-21 0.3 (0.1) 0
Residential Environment
County land area (mi2) (zipc), 2020 2220.8 (1746.9) 0
County land area (m2) (zipc), 2020 50754096.0 (202010000.0) 3.8
Racial segregation level (0-100) (cnty), 2016-20 61.8 (10.4) 0
Childcare centers (per 100K aged <5) (cnty), 2021 5.6 (2.2) 0
Households with broadband internet (cnty), 2016-20 (%) 85.3 (4.5) 0
Avg PM2.5 (cnty), 2018 11.9 (2.3) 0
Population lacking adequate food access (cnty), 2019 (%) 11.6 (2.7) 0
Access to space for physical activity (cnty), 2020-21 (%) 93.8 (10.1) 0
Travel and Transportation
Mean commute time to work (min) (zipc), 2020 28.4 (6.2) 5.8
Workers driving alone to work for >30 min (cnty), 2016-20 (%) 45.4 (7.1) 0
Workforce driving alone to work (cnty), 2016-20 (%) 69.1 (8.4) 0
Motor vehicle crash death rate (per 100K) (cnty), 2014-20 9.0 (2.9) 0
Mean major roadway traffic (vol/m) (cnty), 2019 1917.9 (1181.4) 0
Public transit score (0.0-10.0) (zipc), 2018 7.4 (2.9) 1
Walkability score (0-100) (zipc), 2022 65.3 (26.8) 1
Crime and Substance Use
Violent crime offense rate (per 100K) (cnty), 2014-16 688.0 (418.4) 0
Homicide mortality (per 100K) (cnty), 2014-20 14.6 (13.8) 0
Delinquency case rate (per 1K minors) (cnty), 2019 10.8 (8.4) 1
Drinking water violations present (cnty), 2020 0
- No, % 51.0
- Yes, % 49.0
Age-adj adults reported binge or heavy drinking (cnty), 2019 (%) 19.1 (2.8) 0
Healthcare Access
Adults with no PCP (state), 2021 (%) 14.9 (3.2) 0
Adults not seen HCP in past year due to cost (state), 2021 (%) 8.9 (1.2) 0
Ratio PCPs to population*1000 (cnty), 2019 0.9 (0.2) 0
Ratio dentist to population*1000 (cnty), 2020 0.9 (0.6) 0
Ratio mental health HCPs to population*1000 (cnty), 2021 3.8 (1.2) 0
Ratio of non-physician PCPs to population*1000 (cnty), 2021 1.3 (0.8) 0
<65 uninsured (zipc), 2020 (%) 8.8 (5.6) 5.8
<65 uninsured (cnty), 2019 (%) 9.8 (2.9) 1.9
Adults <65 uninsured (cnty), 2019 (%) 12.8 (3.4) 0
<19 uninsured (cnty), 2019 (%) 4.2 (2.0) 0
Adults uninsured (state), 2019 (%) 8.7 (2.2) 0
Uninsured (cnty), 2019 (%) 10.5 (2.8) 0
Syringe exchanges (state), 2022 21.2 (16.7) 0
Year of Medicaid expansion (state), 2023 2014.0 (0.0) 14.4

Values are means(SD) or medians(Q25, Q75) for continuous variables; percentages or ns or both for categorical variables.

Values of polytomous variables may not sum to 100% due to rounding.

HIV Variables

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(Mean (SD) or % (SD), and % Missing)

(n=104) Missing, %
Prevalence
HIV prevalence (per 100K) (state), 2019 424.1 (109.9) 0
HIV prevalence (per 100K) (cnty), 2020 830.9 (570.2) 9.6
HIV prevalence % (cnty), 2020 (%) 0.8 (0.6) 9.6
HIV prevalence >13 (per 100K) (cnty), 2019 1859.7 (770.9) 72.1
HIV prevalence >13 % (cnty), 2019 (%) 1.9 (0.8) 72.1
People Living with HIV (PLWH) Demographics
13-24 (cnty), 2020 (%) 2.4 (0.8) 10.6
25-34 (cnty), 2020 (%) 15.3 (2.7) 10.6
35-44 (cnty), 2020 (%) 19.0 (2.2) 10.6
45-54 (cnty), 2020 (%) 24.4 (1.2) 10.6
>54 (cnty), 2020 (%) 38.9 (5.6) 10.6
Incidence
Black (cnty), 2020 (%) 38.3 (25.6) 10.6
White (cnty), 2020 (%) 23.2 (9.9) 10.6
Hispanic (cnty), 2020 (%) 30.7 (16.5) 10.6
HIV incidence (per 100K) (state), 2019 14.3 (2.2) 0
Estimated HIV incidence (per 100K) (state), 2019a 12.8 (1.8) 0
HIV incidence (per 100K) (cnty), 2020 19.5 (8.1) 10.6
HIV incidence male (cnty), 2020 (%) 85.0 (5.0) 10.6
HIV incidence female (cnty), 2020 (%) 15.0 (5.0) 10.6
HIV incidence Black (cnty), 2020 (%) 41.9 (25.6) 10.6
HIV incidence White (cnty), 2020 (%) 17.0 (6.2) 10.6
HIV incidence Hispanic (cnty), 2020 (%) 35.5 (18.9) 10.6
Adult adolescent HIV incidence (per 100K) (state), 2020 14.2 (2.3) 0
HIV incidence 13-24 (cnty), 2020 (%) 19.2 (5.1) 10.6
HIV incidence 25-34 (cnty), 2020 (%) 38.1 (2.7) 10.6
HIV incidence 35-44 (cnty), 2020 (%) 20.4 (2.4) 10.6
HIV incidence 45-54 (cnty), 2020 (%) 12.6 (2.6) 10.6
HIV incidence >54 (cnty), 2020 (%) 9.7 (2.4) 10.6
Route of Transmission (by Gender)
PLWH male (cnty), 2020 (%) 82.1 (8.7) 10.6
PLWH male infected via heterosexual contact (cnty), 2020 (%) 6.2 (4.5) 9.6
PLWH male infected via IDU (cnty), 2020 (%) 8.6 (8.8) 7.7
PLWH male infected via sex with men (cnty), 2020 (%) 77.3 (13.6) 2.9
PLWH male infected via sex with men and IDU (cnty), 2020 (%) 7.3 (0.9) 9.6
PLWH male infected through other means (cnty), 2020 (%) 0.7 (0.3) 9.6
PLWH female infected via IDU (cnty), 2020 (%) 23.3 (7.0) 9.6
PLWH female infected via heterosexual contact (cnty), 2020 (%) 73.3 (6.9) 9.6
PLWH female infected via other route (cnty), 2020 (%) 3.4 (0.4) 9.6
AIDS
AIDS incidence (per 100K) (state), 2019 6.3 (1.5) 0
AIDS prevalence (state), 2019 (%) 0.2 (0.1) 0
Criminalization
HIV criminalization laws type (state), 2022 0
- Sentence Enhancement, % 22.1
- General Crime Sentencing, % 4.8
- HIV Law and Gen Crime Sentencing, % 17.3
- Sentence Enhancement and General Crime Sentencing, % 46.2
- None, % 9.6

Values are means(SD) or medians(Q25, Q75) for continuous variables; percentages or ns or both for categorical variables.

Values of polytomous variables may not sum to 100% due to rounding.

a: Estimated time of infection using CD4 depletion model from CDC.