Travel Time to Clinic but not Neighborhood Crime Rate is Associated with Retention in Care Among HIV-Positive Patients
Using geospatial analysis, we examined the relationship of distance between a patient’s residence and clinic, travel time to clinic, and neighborhood violent crime rates with retention in care or viral suppression among people living with HIV (PLWH). For HIV-positive patients at a large urban clinic, we measured distance and travel time between home and clinic and violent crime rate within a two block radius of the travel route. Kruskal–Wallis rank sum was used to compare outcomes between groups. Over the observation period, 2008–2016, 219/602 (36%) patients were retained in care. Median distance from clinic was 3.6 (IQR 2.1–5.6) miles versus 3.9 (IQR 2.7–6.1) miles among those retained versus not retained in care, p = 0.06. Median travel time by car was 15.9 (IQR 9.6–22.9) versus 17.1 (IQR 12.0–24.6) minutes for those retained versus not retained, p = 0.04. Violent crime rate along travel route was not associated with retention. There was no significant association between travel time or distance and viral suppression.
KeywordsRetention in care HIV care continuum Geospatial analysis
This study was funded by a grant from the NIH-funded Third Coast Center for AIDS Research (CFAR) (P30 AI117943).
Compliance with Ethical Standards
Conflict of interest
JR and JS have received grants from Gilead Sciences. The other authors report no conflicts of interest.
This study was approved by the University of Chicago Institutional Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
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