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Journal of Behavioral Medicine

, Volume 42, Issue 2, pp 330–341 | Cite as

The association between symptoms of generalized anxiety disorder and appointment adherence, overnight hospitalization, and emergency department/urgent care visits among adults living with HIV enrolled in care

  • Zachary L. MannesEmail author
  • Lauren E. Hearn
  • Zhi Zhou
  • Jennifer W. Janelle
  • Robert L. Cook
  • Nicole Ennis
Article
  • 248 Downloads

Abstract

This study examined the association between generalized anxiety disorder (GAD) symptoms and healthcare utilization (HCU) among 801 people living with HIV (PLWH). Participants recruited from community health centers in Florida completed questionnaires assessing demographics, substance use, symptoms of GAD and depression, and HCU. Adjusted binary and multinomial logistic regressions assessed the association between moderate-severe GAD symptoms and past 6-month missed HIV-care appointments, overnight hospitalization, and emergency department (ED)/urgent care visits. Participants reporting moderate-severe GAD symptoms had a greater odds of missing an HIV-care appointment (AOR 2.03, 95% CI 1.28–3.24, p = 0.003), spending 2 (AOR 4.35, 95% CI 2.18–8.69, p < 0.001) or 3+ (AOR 2.79, 95% CI 1.20–6.45, p = 0.016) nights in the hospital, and visiting an ED/urgent care facility 2 (AOR 2.63, 95% CI 1.39–4.96, p = 0.003) or 3+ (AOR 2.59, 95% CI 1.27–5.26 p = 0.008) times compared to participants reporting none-mild anxiety. Depression was associated with fewer ED/urgent care visits and overnight hospitalizations, while no association was found with missed primary care appointments. The role of anxiety in illness management remains understudied among PLWH. Anxiety identification and the development of interventions for anxiety among PLWH may have important consequences for healthcare cost saving, patient retention in care, and HIV-disease management.

Keywords

HIV/AIDS Anxiety Appointment adherence Overnight hospitalizations Emergency department visits 

Notes

Acknowledgements

We appreciate the contributions of the research staff and the participants who were involved in the Florida Cohort study. We also appreciate the contributions of the staff within the Florida Department of Health HIV Surveillance unit for helping with data on participant HIV viral load.

Compliance with ethical standards

Conflict of interest

Zachary L. Mannes, Lauren E. Hearn, Zhi Zhou, Jennifer W. Janelle, Robert L. Cook and Nicole Ennis declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical and Health Psychology, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleUSA
  2. 2.Mental Health and Behavioral Sciences ServiceJames A. Haley Veterans’ HospitalLakelandUSA
  3. 3.Department of Epidemiology, College of Public Health and Health Professions and College of MedicineUniversity of FloridaGainesvilleUSA
  4. 4.Department of Infectious Diseases and Global Medicine, College of MedicineUniversity of FloridaGainesvilleUSA

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