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… Click to show full abstract
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.
               
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