The North-South divide: substance use risk, care engagement, and viral suppression among hospitalized HIV-infected patients in 11 U.S. cities.

Regional variability in human immunodeficiency virus (HIV) care engagement remains underexplored. Multiple logistic models compared HIV outcomes for participants from 5 Southern (n = 557) and 6 non-Southern (n = 670) sites. Southern participants were less likely to experience viral suppression (adjusted odds ratio [aOR], 0.52; 95% confidence interval [CI], .37-.72) and had a higher likelihood of a CD4(+) count <200 cells/mu L (aOR, 1.53; 95% CI, 1.17-2.00). HIV intervention and social safety net programs should be expanded.