Factors associated with fewer visits for HIV primary care at a tertiary care center in the SoutheAstern U.S.

Napravnik, Sonia; Eron, Joseph J.; McKaig, Rosemary G.; Heine, Amy; Menezes, Prema; Quinlivan, E. Byrd

doi:10.1080/09540120600838928

Cited by 57 publications

(46 citation statements)

References 13 publications

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“…[33][34][35] Using a conservative measure of retention, two-thirds of our cohort was retained in care; an impressive achievement considering our population was young (mean age of 21), 83% African American, and nearly half reported drug use and/or depressive symptoms. Furthermore, when compared to the 3-year period prior to STYLE, there was a 75% increase the number of new diagnoses among black and Latino MSM aged 17-24 in the 12-county region of the state surrounding where the STYLE intervention occurred (Communicable Disease Branch, NC Division of Public Health, personal communication).…”

Section: Discussionmentioning

confidence: 91%

Keeping Them in “STYLE”: Finding, Linking, and Retaining Young HIV-Positive Black and Latino Men Who Have Sex with Men in Care

Hightow-Weidman

Smith

Valera

et al. 2011

AIDS Patient Care and STDs

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Young men who have sex with men (YMSM) of color are at particularly increased risk for HIV infection compared to white MSM. National data highlight the need to link YMSM of color to care to improve their overall health and stem further infections, yet, there is limited data on interventions and clinical outcomes focused on engaging and retaining youth, specifically HIV-infected YMSM of color in care. To address the medical care needs of this underserved population, in 2005, the Health Research and Services Administration (HRSA) created the YMSM of Color Initiative. Utilizing a social marketing campaign targeting youth and members of their sexual and social networks, testing and outreach on college campuses and within the broader community, and a tightly linked medical-social support network, we created STYLE (Strength Through Youth Livin' Empowered), a novel intervention that sought to diagnose, engage, and retain HIV-positive black and Latino YMSM in HIV primary care services. Over a 3-year period, 81 men were either newly diagnosed or reengaged in care. Overall, 63% of the cohort was retained in clinical care; defined as attending at least one medical visit every 4 months. Compared to the 3 years prior to STYLE, the odds ratio for whether or not someone attended a clinic visit was 2.58 (95% confidence interval [CI] 1.34-4.98) if enrolled in STYLE. We conclude that compared to a pre-STYLE cohort, STYLE was an effective intervention that increased HIV diagnoses, provided efficient and timely engagement in care for both those newly diagnosed and those who had fallen out of care and improved overall retention.

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Section: Discussionmentioning

confidence: 91%

Keeping Them in “STYLE”: Finding, Linking, and Retaining Young HIV-Positive Black and Latino Men Who Have Sex with Men in Care

Hightow-Weidman

Smith

Valera

et al. 2011

AIDS Patient Care and STDs

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“…Most participants reported not paying anything out of pocket for their ART medications and there are numerous AIDS Drug Assistance programmes available in 82 Mississippi counties for individuals without Medicaid or private insurance. However, difficulties in accessing care or making use of existing services, common in the Deep South (Napravnik et al, 2006; may have contributed to 'running out of medications'. Results suggest that further exploring and specifically targeting barriers to having ART medications on hand would be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Reasons for ART non-adherence in the Deep South: Adherence needs of a sample of HIV-positive patients in Mississippi

et al. 2007

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HIV prevalence in the American Deep South has reached crisis proportions and greater numbers of patients are enrolling in clinical care and beginning antiretroviral therapy (ART). In order to gain maximum benefit from ART, patients must sustain high levels of adherence to demanding regimens over extended periods of time. Many patients are unable to maintain high rates of adherence and may need assistance to do so, which may be based upon an understanding of barriers to adherence for a given population. The current study sought to gain understanding of barriers to adherence for a mixed urban/rural HIV-positive patient population in Mississippi and to determine whether barriers to adherence may be specific to gender, employment, depressive symptoms or educational attainment status. Seventy-two patients who missed a dose of ART medication over the last three days endorsed the top five reasons for missing a dose as: (1) not having the medication with them, (2) sleeping through the dose time, (3) running out of the medication, (4) being busy with other things and (5) other. Reported barriers were fairly consistent across different groups, although women and those classified as having moderate to severe depressive symptoms reported different patterns of adherence barriers. Results suggest that adherence interventions implemented in the Deep South must take into account specific barriers faced by individuals within this region, where stigma, gender disparities and limited resources are prevalent.

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“…The UCHCC study and procedures have been described previously. 18 Briefly, the UCHCC includes demographic, clinical, and laboratory data on all participants from electronic institutional records or standardized medical record reviews. Dates of death are ascertained using the NC vital records death certificates and/or family report.…”

Section: Study Populationmentioning

confidence: 99%

Incidence and Clinical Features of Cerebrovascular Disease Among HIV-Infected Adults in the Southeastern United States

Vinikoor

Napravnik

Floris-Moore

et al. 2013

AIDS Research and Human Retroviruses

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With aging of the HIV-infected population, non-AIDS conditions such as cardiovascular disease (CVD) now account for substantial mortality and morbidity. While myocardial infarction is the major outcome of interest in the field of HIV and CVD, cerebrovascular disease remains understudied, especially in the Southeastern United States. We determined the incidence and clinical features of cerebrovascular events (CVE) in a large HIV clinical cohort in North Carolina (NC). A total of 2,515 HIV-infected adults contributed a median of 4.5 years (IQR: 2.0, 7.8) of follow-up. Fifty-three CVEs were adjudicated for an incidence rate of 3.87 per 1,000 person-years (95% CI: 2.90, 5.06). The ischemic stroke incidence was 2.26 per 1,000 person-years (95% CI: 1.53, 3.21), approximately 1.5 times the rate of a population-based cohort in NC. At the time of CVE, the median age was 48 years (IQR: 42, 55). Of ischemic strokes 76% resulted from large artery atherosclerosis or small vessel (lacunar) disease. In multivariable analyses, age, hypertension, dyslipidemia, recent CD4 + cell count £ 200 cells/mm 3 , and recent HIV RNA > 400 copies/ml were associated with an increased risk of CVE. Antiretroviral therapy (ART) was not associated with the risk of CVE. We concluded that in the post-ART era, HIV-infected individuals appear to be at moderately increased risk of stroke. Prevention of CVEs in this population will require modification of traditional CVD risk factors and early, effective treatment of HIV infection.

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Factors associated with fewer visits for HIV primary care at a tertiary care center in the SoutheAstern U.S.

Cited by 57 publications

References 13 publications

Keeping Them in “STYLE”: Finding, Linking, and Retaining Young HIV-Positive Black and Latino Men Who Have Sex with Men in Care

Keeping Them in “STYLE”: Finding, Linking, and Retaining Young HIV-Positive Black and Latino Men Who Have Sex with Men in Care

Reasons for ART non-adherence in the Deep South: Adherence needs of a sample of HIV-positive patients in Mississippi

Incidence and Clinical Features of Cerebrovascular Disease Among HIV-Infected Adults in the Southeastern United States

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