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Risk factors for missed HIV primary care visits among men who have sex with men

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Abstract

Benefits of anti-retroviral therapy (ART) depend on consistent HIV care attendance. However, appointment non-adherence (i.e. missed appointments) is common even in programs that reduce financial barriers. Demographic, health/treatment, and psychosocial contributors to appointment non-adherence were examined among men who have sex with men (MSM) attending HIV primary care. Participants (n = 503) completed questionnaires, and HIV biomarker data were extracted from medical records. At 12 months, records were reviewed to assess HIV primary care appointment non-adherence. Among MSM, 31.2% missed without cancellation at least one appointment during 12-month study period. Independent predictors (P < 0.05) were: low income (OR = 1.87); African American (OR = 3.00) and Hispanic/Latino (OR = 4.31) relative to non-Hispanic White; depression (OR = 2.01); and low expectancy for appointments to prevent/treat infection (OR = 2.38), whereas private insurance (OR = 0.48) and older age (OR = 0.94) predicted lower risk. Low self-efficacy predicted marginal risk (OR = 2.74, P = 0.10). The following did not independently predict risk for non-adherence: education, relationship status, general health, time since HIV diagnosis, ART history, post-traumatic stress disorder, HIV stigma, or supportive clinic staff. Appointment non-adherence is prevalent, particularly among younger and racial/ethnic minority MSM. Socioeconomic barriers, depression and low appointment expectancy and self-efficacy may be targets to increase care engagement.

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Acknowledgment

General funding for this project including data collection was from grant 5R01MH068746-05 and HRSA grant H97HA01293 to Drs. Steven A. Safren and Kenneth H. Mayer. Grant K24MH094214-01 to Dr. Steven A. Safren provided additional support for some investigator time.

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  1. Behavioral Medicine Service, Massachusetts General Hospital/Harvard Medical School, One Bowdoin Square, 7th Floor, Boston, MA, 02114, USA

    Lara Traeger, Conall O’Cleirigh & Steven A. Safren

  2. Fenway Institute, Fenway Health, Boston, MA, USA

    Conall O’Cleirigh, Margie R. Skeer, Kenneth H. Mayer & Steven A. Safren

  3. Brown University Medical School, Providence, RI, USA

    Margie R. Skeer & Kenneth H. Mayer

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  1. Lara Traeger
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  2. Conall O’Cleirigh
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  4. Kenneth H. Mayer
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  5. Steven A. Safren
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Correspondence to Lara Traeger.

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Traeger, L., O’Cleirigh, C., Skeer, M.R. et al. Risk factors for missed HIV primary care visits among men who have sex with men. J Behav Med 35, 548–556 (2012). https://doi.org/10.1007/s10865-011-9383-z

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  • DOI: https://doi.org/10.1007/s10865-011-9383-z

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