title: Factors Associated with Missed Psychiatry Visits in an Urban HIV Clinic.
abstract: Psychiatric co-management is often required in HIV primary care. While rates and clinical impact of linkage and retention in HIV are well explored, fewer investigations focus specifically on linkage to psychiatry. In this investigation, we evaluate factors associated with linkage to psychiatric services using a retrospective cohort study of HIV-infected patients during a two-year observation period. Descriptive statistics depict patient characteristics, and logistic regression models were fit to evaluate factors associated with failure to establish care at the co-located psychiatry clinic following referral from HIV provider. Of 370 referred, 23 % did not attend a scheduled psychiatry appointment within 6 months of initial referral. In multivariable analysis, Non-white race, younger age, non-suppressed viral load, and increased wait time to appointment (in days) were associated with failure to attend. Further exploration of barriers that contribute to disparate linkage to psychiatric care may inform future interventions to improve HIV outcomes in this population.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, BBRB 206B, 845 19th Street S, Birmingham, AL, 35294, USA.
authors.forename: Christina P
authors.initials: CP
authors.lastname: Ho
authors.forename: Anne
authors.initials: A
authors.lastname: Zinski
authors.forename: Susanne A
authors.initials: SA
authors.lastname: Fogger
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Peters
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Westfall
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Lawrence
authors.forename: Christa R
authors.initials: CR
authors.lastname: Nevin
authors.forename: James L
authors.initials: JL
authors.lastname: Raper
authors.forename: Michael S
authors.initials: MS
authors.lastname: Saag
authors.forename: James H
authors.initials: JH
authors.lastname: Willig
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D001071:Appointments and Schedules; D018791:CD4 Lymphocyte Count; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population; D019562:Viral Load