Background There were 28,055 people living with HIV (PLWH) in Miami-Dade County (MDC) in 2017; 40.1% was either out of care or was not virally suppressed (uncontrolled HIV). The purpose of this study was to determine the association between the social determinants of health (SDOH) and the number of persons with uncontrolled HIV in MDC. Setting This cross-sectional study included PLWH 15 and older with uncontrolled HIV in MDC, 2017. Data on PLWH’s viral load, age, gender, mode of HIV transmission, and race/ethnicity were aggregated to the ZIP code level. All five SDOH per HealthyPeople 2020 were represented: economic stability, education, social and community context, health and healthcare, and neighborhood and built environment. Methods Descriptive analyses on all study variables and a principal component analysis on the SDOH variables were performed. To account for overdispersion, multivariate negative binomial regressions were run while controlling for confounders and testing for significant interactions. Results The results of the regression analysis indicated that an increase in Factor 1 (economic stability, education, and health and healthcare determinants) was associated with a statistically significant increase in the number of PLWH with uncontrolled HIV. Additionally, we found a significant interaction between Factor 1 and White race. Among persons of low socioeconomic status, White race is associated with a reduction in PLWH with uncontrolled HIV. Conclusions These results suggest that reducing poverty and increasing education and rates of health insurance should result in significant reductions in PLWH with uncontrolled HIV. These results have the potential to influence future policy, interventions for retention, adherence, and continuity of care to improve suppression rates in MDC.

Background: Self-efficacy is a concept reflected in health behavior models and theories used to describe individual and community behavior. This study identified a reliable measurement of self-efficacy among participants using the Nutrition Empowerment Score (NES). The score was created by the researcher and agency staff to quantify data related to self-efficacy.Methods: Extant post-survey responses from participants of a hands-on nutrition education (HONE) class in a community-based teaching kitchen (n¼89) were analyzed to determine the NES. The NES score was a total score of zero to eight, from low to high, representing increasingly perceived benefits from the cooking class. Cronbach's alpha (a) was used to determine the internal consistency of the NES. Mean NES and a low (0-2), medium (3-5), or high (6-8) NES were used to examine NES among the participant population.Qualitative data from open-ended post-survey responses used inductive analysis to triangulate data related to NES.Results: It was determined that NES was a reliable measure (alpha¼.788). Mean NES (6.56 AE 1.93) and 75% of participants with an NES of 6-8 reflected a high NES among participants. Qualitative statements reflected feelings of empowerment and high self-efficacy were expressed in the open-ended responses and supported the high NES scores from the quantitative findings. Conclusion:Findings suggested that nutrition related self-efficacy was accurately assessed and found to be high among participants in the study. Identifying NES as a reliable scale of measurement allowed researchers to examine the relationship between NES and other research variables in the study.