HIV treatment advancements have transformed a once-terminal diagnosis into a manageable chronic condition. Yet, disparities persist, driven largely by social determinants of health (SDOH). These factors—including factors such as socioeconomic status and housing stability—significantly influence access to care, medication adherence, and health outcomes. Medical providers must be aware of these systemic inequities to achieve the goal of ending the HIV epidemic.
Poverty remains a critical barrier to HIV treatment. According to the Health Resources and Services Administration, individuals with limited financial resources face challenges affording antiretroviral therapy (ART), attending regular appointments, and accessing preventive services (e.g., PrEP). Moreover, food insecurity, prevalent among people with HIV, not only has deleterious effects on overall health but has also been found to compromise adherence to ART regimens.1 Providers should screen for financial and nutritional needs and connect patients with local and national support programs, such as those funded by the Ryan White HIV/AIDS Program.1,2
Housing instability also exerts a profound impact on health outcomes for those living with HIV.3 The Centers for Disease Control and Prevention (CDC) notes that individuals experiencing homelessness are less likely to engage in consistent care and achieve viral suppression.3 Integrating housing assistance programs, such as the Housing Opportunities for Persons With AIDS (HOPWA), into clinical settings can improve outcomes by addressing this fundamental need.4
Structural racism and stigma further exacerbate health disparities. Black and Hispanic populations, who are disproportionately affected by HIV, experience reduced access to care due to systemic inequities.5 According to the Department of Health and Human Services (HHS), culturally competent care and implicit bias training for providers are essential for building trust and reducing disparities.5 Innovative approaches such as partnering with community members, like local barbers, to tackle stigma has proven effective.6
Additionally, transportation barriers, low health literacy, and limited digital access hinder care continuity. Providers should advocate for policies that expand telehealth, improve transportation subsidies, and fund community-based health education programs.5
Addressing SDOH is integral to providing equitable HIV care. By implementing multi-faceted, patient-centered strategies, medical providers can dismantle barriers and foster health equity, paving the way for an HIV-free generation.5
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