Relationships between Patient Race and Residential Race Context with Missed HIV Care Visits in the United States, 2010-2015
AUTHORS
- PMID: 36757336 [PubMed].
ABSTRACT
BACKGROUND: Racial inequities exist in retention in HIV care and multi-level analyses are needed to contextualize and address these differences. Leveraging data from a multi-site clinical cohort of people with HIV (PWH), we assessed the relationships between patient race and residential characteristics with missed HIV care visits.
METHODS: Medical record and patient reported outcome (PRO, including mental health and substance use measures) data were drawn from seven participating Center for AIDS Research Network of Integrated Clinical Systems (CNICS) sites including N = 20,807 PWH from January 2010 through December 2015. Generalized estimating equations were used to account for nesting within individuals and within census tracts in multivariable models assessing the relationship between race and missed HIV care visits controlling for individual demographic and health characteristics and census tract characteristics.
RESULTS: Black PWH resided in more disadvantaged census tracts on average. Black PWH residing in census tracts with higher proportion of Black residents were more likely to miss an HIV care visit. Non-Black PWH were less likely to miss a visit regardless of where they lived. These relationships were attenuated when PRO data were included.
CONCLUSIONS: Residential racial segregation and disadvantage may create inequities between Black PWH and non-Black PWH in retention in HIV care. Multi-level approaches are needed to retain PWH in HIV care accounting for community, healthcare setting, and individual needs and resources.
Tags: 2023 Alumni Publications