{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T15:49:34Z","timestamp":1776872974857,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000085","name":"Ontario HIV Treatment Network","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000085","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023235","name":"Oxford Academic Health Science Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023235","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2024,9]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>Knowledge gaps exist regarding the effects of experiencing child protective services (CPS<\/jats:styled-content>) out\u2010of\u2010home care (e.g. foster homes) among women with HIV<\/jats:styled-content>. We examined whether CPS<\/jats:styled-content> out\u2010of\u2010home care was associated with HIV<\/jats:styled-content> clinical outcome trajectories among women with HIV<\/jats:styled-content> in a longitudinal cohort study in Ontario, British Columbia, and Quebec, Canada.<\/jats:p><\/jats:sec>Methods<\/jats:title>At three timepoints across 5\u2009years (2013\u20132018), we examined self\u2010reported current antiretroviral therapy (ART<\/jats:styled-content>) use and viral load (VL) detectability (>50 copies\/mL). We used latent class growth analysis (LCGA<\/jats:styled-content>) to identify trajectories of ART<\/jats:styled-content> use and VL<\/jats:styled-content> outcomes across study waves. LCGA<\/jats:styled-content> identifies subgroups (classes) with similar trajectories within the sample. We assessed whether HIV<\/jats:styled-content> outcome trajectories could be predicted by CPS<\/jats:styled-content> history. We then conducted a mediation analysis to test whether a mental health latent construct mediated the association between CPS<\/jats:styled-content> history and detectable VL<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>Nearly one\u2010fifth (n<\/jats:italic>\u2009=\u2009272; 19%) of participants (n<\/jats:italic>\u2009=\u20091422; mean age 42.8\u2009years) reported CPS<\/jats:styled-content> out\u2010of\u2010home care. Most participants (89%) were in classes that consistently used ART<\/jats:styled-content> and had an undetectable VL<\/jats:styled-content>. Individuals with CPS<\/jats:styled-content> out\u2010of\u2010home care histories were twice as likely to have a consistently detectable VL<\/jats:styled-content> (\u03b2<\/jats:italic>\u2009=\u20090.72, p<\/jats:italic>\u2009=\u20090.02); there were no differences in ART<\/jats:styled-content> use trajectories. In mediation analyses, we found an indirect path from CPS<\/jats:styled-content> history to a consistently detectable VL via baseline mental health status (\u03b2<\/jats:italic>\u2009=\u20090.02, 95% confidence interval 0.005\u20130.04, p<\/jats:italic>\u2009=\u20090.02), with a significant odds ratio (1.12, z<\/jats:italic>\u2009=\u20092.43, p<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Among women with HIV<\/jats:styled-content> in Canada, experiencing childhood CPS<\/jats:styled-content> out\u2010of\u2010home care was associated with a reduced likelihood of achieving viral suppression, via poorer mental health.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13660","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T07:03:02Z","timestamp":1715929382000},"page":"1051-1057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical HIV<\/scp> outcome trajectories associated with a history of child protective service out\u2010of\u2010home care: Longitudinal cohort findings with women living with HIV in Canada"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-433X","authenticated-orcid":false,"given":"Carmen H.","family":"Logie","sequence":"first","affiliation":[{"name":"Factor\u2010Inwentash Faculty of Social Work University of Toronto Toronto Ontario Canada"},{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Centre for Gender & Sexual Health Equity Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4432-6016","authenticated-orcid":false,"given":"Nina","family":"Sokolovic","sequence":"additional","affiliation":[{"name":"Factor\u2010Inwentash Faculty of Social Work University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Casale","sequence":"additional","affiliation":[{"name":"Factor\u2010Inwentash Faculty of Social Work University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Ndung'u","sequence":"additional","affiliation":[{"name":"Women's Health in Women's Hands Community Health Centre Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. Logan","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Underhill","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Fallon","sequence":"additional","affiliation":[{"name":"Factor\u2010Inwentash Faculty of Social Work University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudette","family":"Cardinal","sequence":"additional","affiliation":[{"name":"BC Centre for Excellence in HIV\/AIDS (BC\u2010CFE) Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Webster","sequence":"additional","affiliation":[{"name":"Faculty of 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