Travel Distance to HIV Medical Care: A Geographic Analysis of Weighted Survey Data from the Medical Monitoring Project in Philadelphia, PA
- 453 Downloads
Decisions regarding where patients access HIV care are not well understood. The purpose of this analysis was to examine differences in travel distance to care among persons receiving care in Philadelphia. A multi-stage sampling design was utilized to identify 400 potential participants. 65 % (260/400) agreed to be interviewed. Participants were asked questions about medical care, supportive services, and geographic location. Distances were calculated between residence and care location. 46.3 % travelled more than three miles beyond the nearest facility. Uninsured travelled further (6.9 miles, 95 % CI 3.9–9.8) than persons with public insurance (3.3 miles, 2.9–3.6). In multivariate analyses, no insurance (20/260) was associated with increased distance (p = 0.0005) and Hispanic ethnicity was associated with decreased distance (p = 0.0462). Persons without insurance travel further but insurance status alone does not explain the variability in distance travelled to care. In Philadelphia, Hispanic populations, and providers that may be most accessible to them, are spatially contained.
KeywordsHIV/AIDS Travel distance Medical care Geographic information systems (GIS) Survey data
The data collection and analysis for this manuscript was supported by the Centers for Disease Control and Prevention grant number 5U62PS001608, distributed as part of the Medical Monitoring Project (FOA PS09-937). Additional support for the collaboration between Philadelphia Department of Public Health and the University of Pennsylvania Center for AIDS Research was provided by Grant numbers AI-045008 and P30 AI 087714.
- 7.Penniman TV, Taylor SL, Bird CE, Beckman R, Collins RL, Cunningham W. The associations of gender, sexual identity and competing needs with healthcare utilization among people with HIV/AIDS. J Nat Med Assoc. 2007;99(4):419–27.Google Scholar
- 20.PDPH. AIDS Activities Coordinating Office (AACO) Surveillance Report (2010), HIV/AIDS in Philadelphia. 2011. Available at: http://www.phila.gov/health/pdfs/2010%20Surveillance%20Preliminary%20Report.pdf. Accessed 11 May 2013.