Chinazo O. Cunningham, MD, Department of Medicine, Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, 3544 Jerome Avenue, Bronx, NY 10467, 718-920-2775, ccunning@montefiore.org, Kate McCoy, PhD, Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, 3544 Jerome Avenue, Bronx, NY 10467, Nancy L Sohler, PhD, MPH, Epidemiology and Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, 2600 Netherland Avenue, Bronx, NY 10463, and Daliah Heller, MPH, CitiWide Harm Reduction, Inc., 260 E. 143rd Street, Bronx, NY 10451.

Background: Treatment with antiretroviral therapy has been shown to improve survival and slow progression of HIV disease. To effectively utilize antiretroviral medications, individuals must access and engage in HIV primary care. In a collaborative study between Montefiore Medical Center and CitiWide Harm Reduction, we describe characteristics of unstably housed HIV-infected individuals in care and out of care.

Methods: 150 HIV-infected single room occupancy hotel residents were interviewed within 30 days of intake at CitiWide. The questionnaire included demographic, health care utilization, HIV disease and treatment, substance use, and housing information. Regular HIV care was defined using several self-report and medical chart variables.

Results: A total of 57% of individuals reported receiving regular care. When compared to those in regular care, individuals out of care were more likely to be young, female, Latino, homosexual, recently incarcerated, and have more depressive symptoms, pain, and a high CD4+ count. In multivariate analysis, individuals with a high CD4+ count, recent incarceration, Latino ethnicity, and threats or experiences with violence were more likely to be out of care (Odds Ratio [OR] =3.4, 2.3, 1.9, 1.6 respectively), while those with a partner were more likely to be in care (OR=1.4). Substance use was not associated with receiving care.

Conclusion: Understanding which demographic and clinical characteristics are associated with receipt of regular HIV primary care is essential to develop effective outreach programs that will facilitate entry and engagement in care, and subsequently reduce current disparities in HIV care.

Learning Objectives:

• To gain a better understanding of individuals who are not in regular HIV primary care in the inner city.

Keywords: Access to Health Care, HIV/AIDS

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.