An Analysis of Place Differences Among New Patient Groups at an HIV Medical Clinic: Project CONNECT

Background: Engagement and consistent HIV care visit attendance are known predictors of favorable clinical outcomes. As a response to this, Project CONNECT (Client Oriented New Patient Navigation to Encourage Connection to Treatment) was launched to improve new patient linkage to care. Methods: The University of Alabama at Birmingham HIV/AIDS Clinic (1917 Clinic) is the largest primary HIV care provider in Alabama. From January 2007 to June 2009, all patients newly presenting to the clinic for treatment attended an orientation prior to their first medical provider visit. Orientation included assessment of psychological barriers to care via interview and self-report questionnaires. Participants were categorized as urban or rural based on their residence address provided at orientation. Univariate analyses were completed to explore differences between the urban and rural groups. Results: Of the sample (n=718), 78.4% were male, and 55.8% were non-White. Ninety-one percent of the sample reported urban residence, while 9% reported residing in rural areas at the time of initial treatment engagement. The urban and rural groups were statistically different (p <0.05) in terms of race, insurance type, engagement category (newly diagnosed, transferring care from another provider, and out of care for >1 year), history of incarceration status, and history of depressive disorder. Conclusion: Differences between new patients categorized as urban or rural suggest that future research should further investigate distinctive barriers and facilitators faced by these groups in relation to longitudinal engagement in care and HIV medical visit adherence.