title: 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.
authors.affiliation: Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7215, USA. napravs@med.unc.edu
authors.forename: Sonia
authors.initials: S
authors.lastname: Napravnik
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Eron
authors.forename: Rosemary G
authors.initials: RG
authors.lastname: McKaig
authors.forename: Amy D
authors.initials: AD
authors.lastname: Heine
authors.forename: Prema
authors.initials: P
authors.lastname: Menezes
authors.forename: Evelyn
authors.initials: E
authors.lastname: Quinlivan
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends; D003695:Delivery of Health Care / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care; D012959:Socioeconomic Factors; D015144:Southeastern United States