Outcomes of HIV-Infected Patients Receiving Care at Multiple Clinics

Baligh R. Yehia, Asher J. Schranz, Florence Momplaisir, Sara C. Keller, Robert Gross, Ian Frank, Joshua P. Metlay, Kathleen A. Brady

Research output: Contribution to journalArticlepeer-review

Abstract

Receiving care at multiple clinics may compromise the therapeutic patient-provider alliance and adversely affect the treatment of people living with HIV. We evaluated 12,759 HIV-infected adults in Philadelphia, PA between 2008 and 2010 to determine the effects of using multiple clinics for primary HIV care. Using generalized estimating equations with logistic regression, we examined the relationship between receiving care at multiple clinics (≥1 visit to two or more clinics during a calendar year) and two outcomes: (1) use of ART and (2) HIV viral load ≤200 copies/mL for patients on ART. Overall, 986 patients (8 %) received care at multiple clinics. The likelihood of attending multiple clinics was greater for younger patients, women, blacks, persons with public insurance, and for individuals in their first year of care. Adjusting for sociodemographic factors, patients receiving care at multiple clinics were less likely to use ART (AOR = 0.62, 95 % CI 0.55–0.71) and achieve HIV viral suppression (AOR = 0.78, 95 % CI 0.66–0.94) than individuals using one clinic. Qualitative data are needed to understand the reasons for visiting multiple clinics.

Original languageEnglish (US)
Pages (from-to)1511-1522
Number of pages12
JournalAIDS and behavior
Volume18
Issue number8
DOIs
StatePublished - Aug 1 2014

Keywords

  • HIV care
  • HIV clinics
  • HIV outcomes
  • Use of multiple clinics
  • Viral suppression

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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