Factors associated with utilization of HAART amongst hard-to-reach HIV-infected individuals in Atlanta, Georgia

Abstract

The study is aimed at identifying clinical, demographic and behavioral factors, including participation in 
HIV care, associated with the utilization of antiretroviral therapy (ART), among hard-to-reach HIV
positive individuals in Atlanta, GA. The study included 184 HIV-positive participants of the Infectious 
Disease Program (IDP) of the Grady Health System between February 1999 to March 2001. Individuals 
were categorized as regular attendees (those who consistently kept their outpatient appointments, n = 
65), irregular (those who inconsistently kept their appointments, n = 60) or non-attendees (those who 
failed routinely to keep their appointments, n = 59). Univariate and multivariate analyses using log
binomial regression modeling were done. HIV-infected individuals who consistently kept their 
appointments at the IDP received ART at a frequency (86%) that is twice that of those who missed some 
appointments (42%) and four times that of those who routinely failed to keep appointments (20%). In 
multivariate analysis, category of clinic attendance (regular, irregular or non-attendee) was the only risk 
factor independently associated with utilization of ART: Regular attendees (RR = 3.59, 95% CI 2.12 to 
6.08) and irregular attendees (RR = 2.26, 95% CI 1.28 to 4.01) compared to non-attendees. The positive 
association between routine clinic attendance and use of antiretroviral therapy observed in this study 
should encourage the development of strategies to retain patients in outpatient HIV care.