208235 Factors Associated with Intermittent HIV Care among a Representative Sample in Los Angeles County, California

Monday, November 9, 2009

Judith Tejero, MPH , Department of Public Health / HIV Epidemiology Program, Los Angeles County, Los Angeles, CA
Rhodri Dierst-Davies, MPH , Department of Public Health / HIV Epidemiology Program, Los Angeles County, Los Angeles, CA
Uchechi Acholonu, MSPH , Department of Public Health / HIV Epidemiology Program, Los Angeles County, Los Angeles, CA
Amy R. Wohl, PhD , Department of Public Health / HIV Epidemiology Program, Los Angeles County, Los Angeles, CA
Background: The successful management of HIV-disease includes regular primary care visits per Public Health Service treatment guidelines (DHHS 2006). However, failure to engage in consistent HIV care has been observed among patients in the US (Shapiro 2000). Factors associated with intermittent HIV care among a representative sample of patients in Los Angeles County (LAC) are examined.

Methods: A representative sample of HIV-infected adults receiving care from January to April 2007 was identified using a 3-stage sampling design. In LAC, patients who had fewer than 2 primary care visits in 9 months were considered in “intermittent care” (n=202); patients with 2 or more visits in this timeframe were considered in “regular care” (n=127). Odds ratios (OR) and t-tests were calculated to examine socio-demographic and clinical characteristics associated with intermittent care.

Results: Factors associated with intermittent care included: current younger age (p=.001), younger age at HIV diagnosis (p=.003), and HIV only status (non-AIDS) (OR=1.7, 95% CI=1.1-2.8). Among those with AIDS, the mean years between an HIV and AIDS diagnosis was greater for those in intermittent care (p=.006). No differences were observed with regard to health insurance status or type, or race/ethnicity.

Conclusions/Implications: HIV patients who were younger, without an AIDS diagnosis, and with more years between an HIV and AIDS diagnosis, were more likely to be in intermittent HIV care. These data are useful for identifying HIV-positive persons who are most likely to fall out of regular care, and may require additional interventions to help them maintain consistent care.

Learning Objectives:
By the end of the session, participants will be able to: 1) Identify factors associated with HIV+ patients in LAC who are less likely to be in regular care for HIV/AIDS

Keywords: Utilization, Care Seeking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Project Coordinator/Data Manager for the Medical Monitoring Project (MMP) study implemented by the Los Angeles County Dept of Public Health in Los Angeles, CA. My responsibilities include: supervising MMP project activities and staff, contributing to study design and data collection instrument development, overseeing data collection and analyses, preparing manuscripts and presenting data to local CBOs, provider groups and other interested government and academic institutions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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