1. Specifically, to consider provider-level or system-level strategies for improving ART adherence and SVS, as these strategies may have broader reach or be more sustainable, and develop interventions to address the social determinants (e.g., economic inequalities) that negatively affect ART use and adherence and viral suppression among PWH."
 
2. "To improve equity in HIV treatment and care outcomes among women with HIV, our findings suggest the need to address racial and ethnic disparities in poverty, need for transportation assistance, health literacy, and consistent health insurance coverage, and need for implementing related solutions that will reduce these inequities in American society."
 
3. With respect to transportation assistance, an estimated 3.6 million patients experience transportation barriers to healthcare each year.28 Women with HIV who are engaged in HIV care can access transportation assistance via the Ryan White HIV/AIDS Program. Structural-level interventions for women needing transportation assistance can also include offering home delivery and 90-day prescriptions (as opposed to 30-day prescriptions)29 and medication synchronization, or the practice of arranging all of a patient's medications to be refilled on the same date.30
 
4. Many racial/ethnic minority women in this study reported limited health literacy, which may translate into low self-efficacy to manage prescriptions-both of which can directly affect medication adherence, and subsequently, based on our findings, SVS. While an individual-level approach to increasing patient self-efficacy to understand and manage prescriptions might be to increase health literacy, intervening at a structural level might involve, for example, providing medication in blister pill packs with the date and time on them for patients who take multiple medications. Identifying and implementing solutions for increasing medication adherence is critical for increasing SVS.
 
5. barriers and facilitators to HIV care engagement among PWH who participated in the MMP from June 2018 to May 2019 and were not engaged in HIV care. Several system- and structural-related facilitators to engaging in care were noted. System-related facilitators included positive attributes of patient-provider relationships (e.g., providers who are empathic, are nonjudgmental, engage patients in a conversation, and take time to listen) and flexible appointments (e.g., scheduled soon after requested or offered outside traditional work hours).31
 
6. Structural-level facilitators of care included transportation (e.g., access to public and private transportation; having available public transportation routes close to home and health care facilities; and reducing, subsidizing or eliminating the cost of transportation); health insurance (e.g., reducing, subsidizing or eliminating cost associated with seeking care); and financial help (e.g., being employed and securing income is a precursor to seeking care).31 If research suggests that PWH in care experience the same issues that those PWH who are of out of care report are barriers to engaging in care, then an argument can be made that those in care are susceptible or at risk of falling out of care if these issues are not addressed. Black and Hispanic/Latina women in this study were "in care" with respect to taking ART, yet disparities in ART adherence and SVS were still evident and associated with structural-level factors like transportation, health insurance, and financial need (i.e., poverty). Simply being "in care" is not enough to reduce these inequities.
 
7. Patient-provider relations and healthcare discrimination are two factors not included in the current analyses (due to changes across MMP cycles that precluded their inclusion) that may help answer the question as to why racial/ethnic disparities in some outcomes were reduced but not eliminated. An important caveat for successfully implementing financial-based structural-level interventions as proposed above is that, before a provider can direct a patient to financial resources that will aid in their ability to be medically adherent, they must first develop a rapport with patients, as a lack of trust can subvert the necessary step of identifying patients who need financial assistance. Negative clinical encounters by racial/ethnic minority women are well documented.32,33 Increasing equitable access to HIV care and treatment services can be accomplished by developing social and structural interventions that address the patient-provider relationship as well as overcoming some of these challenges by providing a "One Stop Shop" (or all-inclusive) module of health-related service delivery.34,35