The contribution of missed clinic visits to disparities in HIV viral load outcomes

Anne Zinski, Andrew O. Westfall, Lytt I. Gardner, Thomas P. Giordano, Tracey E. Wilson, Mari Lynn Drainoni, Jeanne C Keruly, Allan E. Rodriguez, Faye Malitz, D. Scott Batey, Michael J. Mugavero

Research output: Contribution to journalArticle

Abstract

Objectives. We explored the contribution of missed primary HIV care visits ("no-show") to observed disparities in virological failure (VF) among Black persons and persons with injection drug use (IDU) history. Methods. We used patient-level data from 6 academic clinics, before the Centers for Disease Control and Prevention and Health Resources and Services Administration Retention in Care intervention. We employed staged multivariable logistic regression and multivariable models stratified by no-show visit frequency to evaluate the association of sociodemographic factors with VF. We used multiple imputations to assign missing viral load values. Results. Among 10 053 patients (mean age = 46 years; 35% female; 64% Black; 15% with IDU history), 31% experienced VF. Although Black patients and patients with IDU history were significantly more likely to experience VF in initial analyses, race and IDU parameter estimates were attenuated after sequential addition of no-show frequency. In stratified models, race and IDU were not statistically significantly associated with VF at any no-show level. Conclusions. Because missed clinic visits contributed to observed differences in viral load outcomes among Black and IDU patients, achieving an improved understanding of differential visit attendance is imperative to reducing disparities in HIV.

Original languageEnglish (US)
Pages (from-to)2068-2075
Number of pages8
JournalAmerican Journal of Public Health
Volume105
Issue number10
DOIs
StatePublished - Oct 1 2015

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Ambulatory Care
Viral Load
HIV
Injections
Pharmaceutical Preparations
United States Health Resources and Services Administration
History
Centers for Disease Control and Prevention (U.S.)
Primary Health Care
Logistic Models

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Zinski, A., Westfall, A. O., Gardner, L. I., Giordano, T. P., Wilson, T. E., Drainoni, M. L., ... Mugavero, M. J. (2015). The contribution of missed clinic visits to disparities in HIV viral load outcomes. American Journal of Public Health, 105(10), 2068-2075. https://doi.org/10.2105/AJPH.2015.302695

The contribution of missed clinic visits to disparities in HIV viral load outcomes. / Zinski, Anne; Westfall, Andrew O.; Gardner, Lytt I.; Giordano, Thomas P.; Wilson, Tracey E.; Drainoni, Mari Lynn; Keruly, Jeanne C; Rodriguez, Allan E.; Malitz, Faye; Batey, D. Scott; Mugavero, Michael J.

In: American Journal of Public Health, Vol. 105, No. 10, 01.10.2015, p. 2068-2075.

Research output: Contribution to journalArticle

Zinski, A, Westfall, AO, Gardner, LI, Giordano, TP, Wilson, TE, Drainoni, ML, Keruly, JC, Rodriguez, AE, Malitz, F, Batey, DS & Mugavero, MJ 2015, 'The contribution of missed clinic visits to disparities in HIV viral load outcomes', American Journal of Public Health, vol. 105, no. 10, pp. 2068-2075. https://doi.org/10.2105/AJPH.2015.302695
Zinski A, Westfall AO, Gardner LI, Giordano TP, Wilson TE, Drainoni ML et al. The contribution of missed clinic visits to disparities in HIV viral load outcomes. American Journal of Public Health. 2015 Oct 1;105(10):2068-2075. https://doi.org/10.2105/AJPH.2015.302695
Zinski, Anne ; Westfall, Andrew O. ; Gardner, Lytt I. ; Giordano, Thomas P. ; Wilson, Tracey E. ; Drainoni, Mari Lynn ; Keruly, Jeanne C ; Rodriguez, Allan E. ; Malitz, Faye ; Batey, D. Scott ; Mugavero, Michael J. / The contribution of missed clinic visits to disparities in HIV viral load outcomes. In: American Journal of Public Health. 2015 ; Vol. 105, No. 10. pp. 2068-2075.
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