Factors associated with fewer visits for HIV primary care at a tertiary care center in the SoutheAstern U.S.

Abstract

In this study we sought to evaluate sociodemographic and clinical characteristics associated with decreased access to HIV outpatient care in a University-based clinic in the Southeastern U.S. The number of HIV outpatient clinic visits per person-year was estimated among 1,404 HIV-infected individuals participating in a large observational clinical cohort study. On average, participants attended 3.38 visits per person-year (95% CI = 3.32, 3.44), with 71% attending fewer than 4 visits per year. Younger persons, of Black race/ethnicity, with less advanced HIV disease, and a shorter time from entry to HIV care, had poorer access to care, as did participants without health insurance and residing a greater distance from care. Vulnerable subgroups of HIV-infected patients in the South have decreased access to ongoing HIV health care. Interventions including more intensive counseling and active outreach for newly HIV diagnosed individuals and support with obtaining health insurance and transportation may lead to improved outcomes.

Acknowledgments

This study was supported by The University of North Carolina at Chapel Hill, Center for AIDS Research, National Institutes of Health funded program #P30 AI 50410; funds from the US Department of Health and Human Services, HRSA, HAB, Office of Science and Epidemiology; the Epidemiology Department at GlaxoSmithKline; SAS Institute; and The Medical Foundation of North Carolina, Inc. We greatly appreciate the support of all study staff members, HIV care providers, and particularly the individuals who participated in this study.