Among people living with HIV (PLWH) in Florida, <2/3 are virally suppressed (viral load <200 copies/mL). Previous theoretical frameworks have pointed to HIV-related stigma as an important factor for viral suppression; an important outcome related to the HIV continuum of care. This study aims to analyze the association between enacted HIV-related stigma and antiretroviral therapy (ART) adherence and viral suppression among a sample of PLWH in Florida. The overall sample (n = 932) was male (66.0%), majority greater than 45 years of age (63.5%), black (58.1%), and non-Hispanic (79.7%). Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated using logistic regression models. The odds of nonadherence to ART was not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs. no stigma) [AOR = 1.30, CI: (0.87–1.95), p = 0.198; AOR = 1.17, CI: (0.65–2.11), p = 0.600, respectively]. Moreover, the odds of nonviral suppression were not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs. no stigma) [AOR = 0.92, CI: (0.60–1.42), p = 0.702; AOR = 1.16, CI: (0.64–2.13), p = 0.622, respectively]. However, ever experiencing health care-specific enacted HIV-related stigma was associated with both nonadherence [AOR = 2.29, CI: (1.25–4.20), p = 0.008] and nonsuppression [AOR = 2.16, CI: (1.19–3.92), p = 0.011]. Despite limitations, the results suggest that the perpetuation of stigma by health care workers may have a larger impact on continuum of care outcomes of PLWH than other sources of enacted stigma. Based on the results, there is a need to develop and evaluate interventions for health care workers intended to reduce experienced stigma among PLWH and improve health outcomes.

In 2013, Florida had the highest rate of new HIV infections and only 56% of persons living with HIV (PLWH) were virally suppressed. In response, we initiated a new HIV cohort in Florida to better understand issues affecting HIV health outcomes. This manuscript will describe the procedures of the Florida Cohort; summarize information regarding enrollment, follow-up, and findings to date; and discuss challenges and lessons learned during the establishment of a multisite cohort of PLWH. Florida Cohort participants were enrolled from eight clinics and community-based organizations geographically diverse counties across Florida. Data were obtained from participant questionnaires, medical records, and state surveillance data. From 2014–2018, 932 PLWH (44% ≥50 years, 64% male, 55% black, 20% Latinx) were enrolled. At baseline, 83% were retained in care and 75% were virally suppressed. Research findings to date have focused on outcomes such as the HIV care continuum, HIV-related comorbidities, alcohol and drug use, and mHealth interventions interest. Strengths included the diversity of the sample and the linkage of participant surveys with existing surveillance data. However, the study had several challenges during planning and follow-up. The lessons learned from this study can be helpful when initiating a new longitudinal cohort study.