title: The effect of driving distance from medical treatment facility and short-term management outcomes in Department of Defense beneficiaries newly diagnosed with human immunodeficiency virus.
abstract: Access to experienced providers is an important part of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome management, especially for patients who are just starting a new or complicated treatment regimen. To date, few studies have addressed the potential barrier of geographic distance in access to care in the HIV/acquired immunodeficiency syndrome population. We performed a retrospective study examining the effects of driving distance from a major Naval medical treatment facility on clinical outcomes for Department of Defense beneficiaries recently diagnosed with HIV. The outcomes studied include attainment of undetectable HIV-1 RNA levels and change in mean CD4+ T cell counts 6 months after initiation of management in 132 Department of Defense beneficiaries. We found no significant associations between distance from a major medical treatment facility and these clinical outcomes through 6 months of follow-up. These findings suggest that stationing HIV-infected military personnel far from major Medical Treatment Facility does not interfere with initial successful HIV management.
authors.affiliation: Department of Preventive Medicine & Biometrics, Uniformed Services University, Bethesda, MD 20814, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Riddle
authors.forename: David L
authors.initials: DL
authors.lastname: Blazes
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wallace
authors.forename: Sybil
authors.initials: S
authors.lastname: Tasker
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008889:Military Personnel; D009326:Naval Medicine; D012189:Retrospective Studies; D016896:Treatment Outcome