Factors associated with retention in care for persons living with HIV in non-urban Western Colorado.

Autor/Urheber	Graham, Lucy
Titel	Factors associated with retention in care for persons living with HIV in non-urban Western Colorado.
Quelle	University of Colorado at Denver, Anschutz Medical Campus. Health Sciences Library (2016) PDF als Volltext kostenfreie Datei
Sprache	englisch
Dokumenttyp	online; Monographie
Schlagwörter	Non Urban; Adult; HIV; Patient Compliance; Colorado; United States
Abstract	Includes bibliographical references. ; Summer ; The vast majority of people living with HIV are not retained in regular care, although retention in care is critical to reducing HIV-associated morbidity and mortality. Current research on retention in HIV care is heavily focused on urban populations. Informed by a theoretical framework and existing literature, we explored predictors of retention in care and viral suppression (HIV RNA PCR ≤ 200 copies/mL) among English- or Spanish-speaking people living with HIV in a predominately rural region of Colorado. Retention in care is defined as no missed visits ("no shows"). Through surveys and electronic medical record data, we obtained information on distance from participants' residence to clinic, rurality, age, gender, race/ethnicity, education, HIV risk factor, country of origin, years living with HIV, health literacy, substance abuse, depression, coping, health locus of control, and the patient relationship with the health care team. Of 127 participants (mean age = 49 years; 65% male; 70% White), 48% attended or canceled in advance all HIV visits while 52% missed one or more visits after first entering care at the clinic. In this study, 97% of participants were virally suppressed based on one HIV viral load obtained closest to survey completion. Living farther from the clinic, health literacy, residing in a more rural versus urban area, HIV risk factors of heterosexual contact and injection drug use versus men having sex with men, and screening positive for depression decreased the odds of being retained in HIV care. Denial and substance use coping mechanisms were also found to decrease the odds of being retained in care, however, only denial coping mediated the effects of health literacy, depression, and reporting heterosexual contact versus men who have sex with men as an HIV risk factor on retention in care. Understanding more about how to successfully retain people living with HIV in care over time is essential regardless of residence, but people living with HIV in rural areas require special considerations.
Anmerkungen	Graham_ucdenveramc_1639D_10333.pdf; ETD Data Dictionary 1.1
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