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Thesis
Examining the Retention of HIV Positive Patients who attend the Drexel Partnership Comprehensive Care Practice
Master of Public Health (M.P.H.), Drexel University
2012
DOI:
https://doi.org/10.17918/etd-4084
Abstract
Introduction: HIV positive individuals who remain in care are shown to be healthier and live longer than those who do not (Christopoulos, Das, & Colfax, 2010; Janet M. Blair, 2011; Stephen D. Lawn, 2007). It is estimated 50% of known HIV-infected individuals in the United States are not engaged in regular HIV care (Gardner, McLees, Steiner, del Rio, & Burman, 2011). In order to effectively reduce the prevalence of HIV/AIDS in the United States, there is a need for the development of better retention methods. Purpose: The purpose of this study is to identify characteristics of patients, which attend the Partnership Comprehensive Care Practice, who are at a highest risk of being lost to care. Hypothesis: It is hypothesized those who are lost to care will have detectable viral loads, CD4 counts less than 500 cells/mm3, and not have private insurance. Method: Using SAS Version 9.2, univariate analyses were conducted to display the distribution of patient characteristics (independent variables) from 2010 - 2011. After a general distribution was assessed, the independent variables were stratified by retention status. The Mantel-Haenszel Chi-Square procedure was performed to test whether there is a significant linear association, on an ordinal scale, between the independent variables of interest and the three leveled retention measure. Variables were deemed to have a significant association with retention status if p-values were less than 0.05. Multiple logistic regressions were used to calculate the risk of patients not being retained in care in regards to patient demographics and HIV/AIDS indicator variablesResults: Mantel-Haenszel Chi-Square statistics showed there were significant associations between viral loads and retention status (p<0.0001), as well as, between CD4 cell counts and retention status ((p<0.0001). There was not a significant association found between insurance type and retentions status (0.08). During 2010, women had a 52% increased risk not being optimally retained in care. In that same year women had a 65% increased risk of not being sub optimally retained in care. Injection drug users had a 91% increased risk of not being sub optimally retained in care and men who have sex with men (MSM) had a 68% increased risk of not being sub optimally retained in care. Patients whose primary insurance was classified as private had a 156% increased risk of not being optimally retained in care and 74% increased risk of not being sub optimally retained in care. The results of those privately insured was influenced by factors that was not due to privately insured patients missing medical visits, but due to the fact that the definition of retention used did not adequately assess this population. Hispanic patients were found to have a 60% decreased likelihood of being sub-optimally retained in care. Conclusion: Results from this study shows there are populations in the clinic who are in need of targeted inventions in order to enroll them back in to care. Further researcher should focus on the reasons why patients belonging to these populations are more likely not to be retained in care.
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Details
- Title
- Examining the Retention of HIV Positive Patients who attend the Drexel Partnership Comprehensive Care Practice
- Creators
- Darryl Fields - DU
- Awarding Institution
- Drexel University
- Degree Awarded
- Master of Public Health (M.P.H.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Thesis
- Language
- English
- Academic Unit
- School of Public Health (2002-2015); Drexel University
- Other Identifier
- 4084; 991014631954304721