Factors associated with use of HIV primary care among persons recently diagnosed with HIV: Examination of variables from the behavioural model of health-care utilization

Abstract

The delay between testing positive for human immunodeficiency virus (HIV) and entering medical care can be better understood by identifying variables associated with use of HIV primary care among persons recently diagnosed with the virus. We report findings from 270 HIV-positive persons enrolled in the Antiretroviral Treatment Access Study (ARTAS). 74% had not seen an HIV care provider before enrolment; 26% had one prior visit only. Based on Andersen's behavioural model of health care utilization, several variables reflecting demographic, healthcare, illness, behavioural, and psychosocial dimensions were assessed and used to predict the likelihood that participants had seen an HIV care provider six months after enrolment. Overall, 69% had seen an HIV care provider by six months. In multivariate analysis, the likelihood of seeing a provider was significantly (p<.05) higher among men, Hispanics (vs. non-Hispanic Blacks), those with higher education, those who did not use injection drugs, those with three or more HIV-related symptoms, those with public health insurance (vs. no insurance), and those who received short-term case management (vs. passive referral). The findings support several conceptual categories of Andersen's behavioural model of health services utilization as applied to the use of HIV medical care among persons recently diagnosed with HIV.

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Acknowledgments

The ARTAS study group consists of the authors and Dr. Scott D. Holmberg, Dr. Stephanie L. Sansom, Dr. Ramses Sadek, Zaneta Gaul and Christopher S. Krawczyk from the Centers for Disease Control and Prevention; Sonya Green, Maribel Barragan, Dr. Wayne Duffus, Dr. Michael Leonard, Christine O'Daniels, Catherine Abrams, Felicia Berry, Valerie Hunter, Howard Pope, and Giselle C. Hicks from the Emory University School of Medicine, Division of Infectious Diseases; Dr. Steffanie Strathdee, Steven Huettner, Matt Woolf, Ovedia Burt, and Janet Reaves, from the Johns Hopkins Bloomberg School of Public Health; Dr. Peter Kerndt, Bobby Gatson, Brandon Schmidt, Norma Perez, Amy Chan, Lawrence Fernandez, Jr., Shannon Curreri, Eric Valera, Stella Gutierrez, from Health Research Association; Dr. Clyde McCoy, Dr. Gordon Dickinson, Dr. Toye Brewer, Dr. Orlando Gomez, Brad Wohler-Torres, Lauren Gooden, Dr. Wei Zhao, Faye Yeomans, and Yolanda Davis Camacho from the University of Miami School of Medicine; Dr. Harvey A. Siegal, Richard C. Rapp, Teri L. Rust, and Dr. Jichuan Wang, from the Wright State University School of Medicine.

Notes

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.