title: Assessment of a medical outreach program to improve access to HIV care among marginalized individuals.
abstract: Marginalized populations are disproportionately affected by HIV, yet they have poor access to health services. Outreach programs focus on improving access, but few are evaluated. We assessed a medical outreach program targeting unstably housed, HIV-infected individuals. We extracted data from 2003-2005 to examine whether keeping medical appointments was associated with patient and program characteristics. Patients kept appointments more frequently when they were walk-in or same-day appointments (compared with future appointments; adjusted odds ratio [AOR]=1.69; 95% confidence interval [CI] = 1.38, 2.08), when they were at a community-based organization's drop-in center (compared with single-room occupancy hotels; AOR=2.50; 95% CI=1.54, 4.17), or when made by nonmedical providers (compared with medical providers; future appointments: AOR = 1.38; 95% CI = 1.05, 1.80; same-day appointments: AOR = 1.70; 95% CI = 1.03, 2.81). These findings demonstrate the importance of program-related characteristics in health services delivery to marginalized populations.
authors.affiliation: Division of General Internal Medicine and Department of Family and Social Medicine at Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY 10467, USA. ccunning@montefiore.org
authors.forename: Chinazo O
authors.initials: CO
authors.lastname: Cunningham
authors.forename: John Paul
authors.initials: JP
authors.lastname: Sanchez
authors.forename: Daliah I
authors.initials: DI
authors.lastname: Heller
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Sohler
mesh_terms: D001071:Appointments and Schedules; D003159:Community-Institutional Relations; D015658:HIV Infections; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006798:Housing; D006801:Humans; D009519:New York City; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care