{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:09:10Z","timestamp":1787018950780,"version":"build-2736575974"},"reference-count":45,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN154325"],"award-info":[{"award-number":["FDN154325"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002879","name":"Canadian HIV Trials Network, Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CTN 262"],"award-info":[{"award-number":["CTN 262"]}],"id":[{"id":"10.13039\/501100002879","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Greater Toronto Area (GTA) is home to 39% of Canada\u2019s population living with HIV. To identify gaps in access and engagement in care and treatment, we assessed the care cascade of women living with HIV (WLWH) in the GTA versus the rest of Ontario and Canada (in this case: Quebec and British Columbia).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 2013\u20132015 self-reported baseline data from the Canadian HIV Women\u2019s Sexual and Reproductive Health Cohort Study for six care cascade stages: linked to care, retained in care, initiated antiretroviral therapy (ART), currently on ART, ART adherence (\u226590%), and undetectable (&lt;50\u00a0copies\/mL). Multivariable logistic regression was used to reveal associations with being undetectable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Comparing the GTA to the rest of Ontario and Canada, respectively: 96%, 98%, 100% were linked to care; 92%, 94%, 98% retained in care; 72%, 89%, 96% initiated ART; 67%, 81%, 90% were currently using ART; 53%, 66%, 77% were adherent; 59%, 69%, 81% were undetectable. Factors associated with viral suppression in the multivariable model included: living outside of the GTA (Ontario: aOR = 1.72, 95% CI: 1.09\u20132.72; Canada: aOR = 2.42, 95% CI: 1.62\u20133.62), non-Canadian citizenship (landed immigrant\/permanent resident: aOR = 3.23, 95% CI: 1.66\u20136.26; refugee\/protected person\/other status: aOR = 4.77, 95% CI: 1.96\u201311.64), completed high school (aOR = 1.77, 95% CI: 1.15\u20132.73), stable housing (aOR = 2.13, 95% CI: 1.33\u20133.39), income of \u2265$20,000 (aOR = 1.52, 95% CI: 1.00\u20132.31), HIV diagnosis &lt;6\u00a0years (6\u201314\u00a0years: aOR = 1.75, 95% CI: 1.16\u20132.63; &gt;14\u00a0years: aOR = 1.87, 95% CI: 1.19\u20132.96), and higher resilience (aOR = 1.02, 95% CI: 1.00\u20131.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>WLWH living in the GTA had lower rates of viral suppression compared to the rest of Ontario and Canada even after adjustment of age, ethnicity, and HIV diagnosis duration. High-impact programming for WLWH in the GTA to improve HIV outcomes are greatly needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624221108034","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T22:12:28Z","timestamp":1669068748000},"page":"4-17","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["HIV care cascade for women living with HIV in the Greater Toronto Area versus the rest of Ontario and Canada"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1050-6067","authenticated-orcid":false,"given":"Priscilla","family":"Medeiros","sequence":"first","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Warren","sequence":"additional","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Kazemi","sequence":"additional","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Notisha","family":"Massaquoi","sequence":"additional","affiliation":[{"name":"Faculty of Social Work, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Smith","sequence":"additional","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangari","family":"Tharao","sequence":"additional","affiliation":[{"name":"Women\u2019s Health in Women\u2019s Hands Community Health, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Serghides","sequence":"additional","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"},{"name":"Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada"},{"name":"Department of Immunology, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-433X","authenticated-orcid":false,"given":"Carmen H","family":"Logie","sequence":"additional","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"},{"name":"Faculty of Social Work, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Kroch","sequence":"additional","affiliation":[{"name":"Ontario HIV Treatment Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann N","family":"Burchell","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6809-1357","authenticated-orcid":false,"given":"Alexandra","family":"de Pokomandy","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada"},{"name":"Department of Family Medicine, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Kaida","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7887-8997","authenticated-orcid":false,"given":"Mona","family":"Loutfy","sequence":"additional","affiliation":[{"name":"Women\u2019s College Research Institute, Women\u2019s College Hospital, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada"},{"name":"Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"On behalf of the CHIWOS Research Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"bibr1-09564624221108034","unstructured":"Paris Declaration. Fast-track cities: ending the AIDS epidemic. Available at: https:\/\/www.iapac.org\/files\/2018\/07\/Fast-Track-Cities-Paris-Declaration_01DEC14.pdf (2014, accessed 9 April 2020)."},{"key":"bibr2-09564624221108034","unstructured":"United Nations General Assembly. Political declaration on HIV and AIDS: On the fast track to accelerating the fight against HIV and to ending the AIDS epidemic by 2030. Available at: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2016-political-declaration-HIV-AIDS_en.pdf (2016, accessed 7 July 2020)."},{"key":"bibr3-09564624221108034","unstructured":"UNAIDS. 90-90-90 an ambitious treatment target to help end the AIDS epidemic. Available at: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/90-90-90_en.pdf (2014, accessed 20 June 2020)."},{"key":"bibr4-09564624221108034","unstructured":"UNAIDS. Cities ending the AIDS pandemic. Available at: https:\/\/www.iapac.org\/files\/2018\/07\/cities-report-16JUN16.pdf (2016, accessed 11 April 2020)."},{"key":"bibr5-09564624221108034","unstructured":"Toronto to Zero. The future of HIV care in Toronto. Available at: https:\/\/torontotozero.ca\/resources\/ (2019, accessed 7 March 2020)."},{"key":"bibr6-09564624221108034","unstructured":"Ontario HIV Treatment Network. Women and HIV in Ontario. Available at: https:\/\/www.aidsnetwork.ca\/sites\/default\/files\/WHAIfactsheet-WomenandHIV2015%282%29.pdf (2015, accessed 8 July 2020)."},{"key":"bibr7-09564624221108034","unstructured":"Public Health Agency of Canada. HIV and AIDS in Canada: surveillance report to December 31, 2014. Available at: https:\/\/www.canada.ca\/content\/dam\/canada\/health-surveillance-2014-vih-sida\/alt\/hiv-aids-surveillance-2014-vih-sida-eng.pdf (2014, accessed 2 June 2020)."},{"key":"bibr8-09564624221108034","volume-title":"Facing the future together: an innovative response to the urgent HIV\/AIDS crisis in Toronto","author":"Gough K","year":"2011"},{"key":"bibr9-09564624221108034","unstructured":"Ontario HIV Epidemiology and Surveillance Initiative. New HIV diagnoses in Ontario: preliminary update. Available at: http:\/\/www.ohesi.ca\/documents\/OHESI-New-HIV-Diagnoses-preliminary-updates.pdf (2016, accessed 7 July 2020)."},{"key":"bibr10-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2015.0139"},{"key":"bibr11-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115277"},{"key":"bibr12-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000200"},{"key":"bibr13-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210096"},{"key":"bibr14-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2014.954703"},{"key":"bibr15-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-019-0309-3"},{"key":"bibr16-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184708"},{"key":"bibr17-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1353\/cpr.2018.0003"},{"key":"bibr18-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2006.08.001"},{"key":"bibr19-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1177\/135910539700200305"},{"key":"bibr20-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(18)30622-6"},{"key":"bibr21-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0040793"},{"issue":"2","key":"bibr22-09564624221108034","first-page":"165","volume":"1","author":"Wagnild G","year":"1993","journal-title":"J Nurs Meas"},{"key":"bibr23-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1177\/1049731507309830"},{"key":"bibr24-09564624221108034","doi-asserted-by":"publisher","DOI":"10.7249\/CB361"},{"key":"bibr25-09564624221108034","volume-title":"SF-36 physical and mental health summary scales: a user\u2019s manual","author":"Ware J","year":"1994"},{"key":"bibr26-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001775"},{"key":"bibr27-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-2453-8"},{"key":"bibr28-09564624221108034","volume-title":"WCBR project-involving Ontario HIV-positive women and their service providers in determining research needs and priorities","author":"Morshed M","year":"2013"},{"key":"bibr29-09564624221108034","volume-title":"Women in a globalized world, transforming equality, development, diversity and peace","author":"Tharao W","year":"2013","edition":"1"},{"key":"bibr30-09564624221108034","volume-title":"Women and HIV prevention in Canada: implications for research, policy, and practice","author":"Tharao W","year":"2013","edition":"1"},{"key":"bibr31-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001124"},{"issue":"4","key":"bibr32-09564624221108034","first-page":"325","volume":"22","author":"Benoit A","year":"2016","journal-title":"Antivir Ther"},{"key":"bibr33-09564624221108034","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17228343"},{"key":"bibr34-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001134"},{"key":"bibr35-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001671"},{"key":"bibr36-09564624221108034","doi-asserted-by":"publisher","DOI":"10.17269\/s41997-018-0104-z"},{"key":"bibr37-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010562"},{"issue":"10","key":"bibr38-09564624221108034","first-page":"437","volume":"31","author":"Kronfil N","year":"2017","journal-title":"AIDS Patient Care STDs"},{"key":"bibr39-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1926-z"},{"key":"bibr40-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2011.0178"},{"key":"bibr41-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2301-4"},{"key":"bibr42-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/963474"},{"key":"bibr43-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-8052-y"},{"key":"bibr44-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02601-w"},{"key":"bibr45-09564624221108034","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239190"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624221108034","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624221108034","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624221108034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:43:35Z","timestamp":1777675415000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624221108034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,21]]},"references-count":45,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1177\/09564624221108034"],"URL":"https:\/\/doi.org\/10.1177\/09564624221108034","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,21]]}}}