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Predictors of Barriers to Medical Care Among People Living with HIV in New York City: Changes from 2002 to 2017

Zhao, Gagarin

Background. Studies have shown that barriers to medical care remain a notable issue in the HIV epidemic. However, few researchers have examined how individual characteristics such as race, gender, poverty, mental health, physical health, and age affect different types of barriers to long-term medical care.

Aims. This study addressed these limitations by analyzing data from a prospective cohort of HIV-positive individuals in New York City.
Method. The sample consisted of HIV-positive individuals in New York City (n = 1329). Self-reported experience of barriers to medical care were obtained. Three non-overlapping cohorts recruited approximately four years apart between 2002 and 2017 were used: 2002-04, 2008-11, and 2015-17. Data was examined using a repeated cross-section design with multivariable logistic regression.

Results. There was fluctuation overtime in participant report of different types of barriers with indication of improvements over time. Gender and mental health component score (MCS) were found to be the most strongly associated with barriers to medical care. Between 2002-04 and 2008-11, low mental health functioning (MCS) became less of a barrier to care; one point lower on the MCS scale is associated with lower odds of reporting barriers (AOR: 0.969 deceased to 0.915). Males had comparatively lower odds of reporting barriers between 2002-04, but on average had more than twice the odds of experiencing barriers compared with women in 2008-2011 (AOR: 0.665 to 2.167).

Conclusion. The final model showed inconclusive but encouraging signs that there have been reductions in barriers to HIV medical care over the past 15 years.

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More About This Work

Academic Units
Sociomedical Sciences
Thesis Advisors
Aidala, Angela A.
Degree
M.P.H., Mailman School of Public Health, Columbia University
Published Here
May 4, 2020