Antiretroviral adherence among rural compared to urban veterans with HIV infection in the United States

Michael E Ohl; Eli Perencevich; D Keith McInnes; Nancy Kim; David Rimland; Kathleen Akgun; David A Fiellin; Melissa Skanderson; Karen Wang; Amy Justice

doi:10.1007/s10461-012-0325-8

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Antiretroviral adherence among rural compared to urban veterans with HIV infection in the United States

Journal article

Peer reviewed

Antiretroviral adherence among rural compared to urban veterans with HIV infection in the United States

Michael E Ohl, Eli Perencevich, D Keith McInnes, Nancy Kim, David Rimland, Kathleen Akgun, David A Fiellin, Melissa Skanderson, Karen Wang and Amy Justice

AIDS and behavior, Vol.17(1), pp.174-180

01/2013

DOI: 10.1007/s10461-012-0325-8

PMID: 23080359

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Abstract

Rural-dwelling persons with HIV infection face barriers to maintaining high levels of antiretroviral adherence. We compared adherence among 1,782 rural and 18,519 urban veterans initiating antiretroviral therapy in the Veterans Affairs (VA) healthcare system in the United States between 1998 and 2007. Residence was determined using rural urban commuting area codes and adherence using pharmacy-based refill measures. The median proportion of days covered (PDC) by combination antiretroviral therapy in the first year of treatment ranged from 0.72 among urban residents to 0.79 among rural-small town/remote residents (p < 0.0001). In multivariable logistic regression, predictors of high adherence (PDC greater than 0.90) were residence in a rural-small town/remote setting (odds ratio 1.24, 95 % CI 1.09-1.56, relative to urban), increasing age, white race, absence of an alcohol or substance use disorder, and absence of hepatitis C infection. Results may differ outside VA healthcare, where there may be fewer resources to support adherence among rural-dwelling persons with HIV.

United States

Medication Adherence - statistics & numerical data

Residence Characteristics

Anti-Retroviral Agents - therapeutic use

Confidence Intervals

Rural Population - statistics & numerical data

Urban Population - statistics & numerical data

Medication Adherence - psychology

Follow-Up Studies

Humans

Middle Aged

Logistic Models

Male

Socioeconomic Factors

Adult

Female

HIV Infections - drug therapy

United States Department of Veterans Affairs

Retrospective Studies

Veterans - statistics & numerical data

Odds Ratio

Details

Title: Subtitle: Antiretroviral adherence among rural compared to urban veterans with HIV infection in the United States
Creators: Michael E Ohl - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region, Iowa City VA Medical Center, Iowa City, IA, USA. michael-ohl@uiowa.edu
Eli Perencevich
D Keith McInnes
Nancy Kim
David Rimland
Kathleen Akgun
David A Fiellin
Melissa Skanderson
Karen Wang
Amy Justice
Resource Type: Journal article
Publication Details: AIDS and behavior, Vol.17(1), pp.174-180
Publisher: United States
DOI: 10.1007/s10461-012-0325-8
PMID: 23080359
ISSN: 1090-7165
eISSN: 1573-3254
Language: English
Date published: 01/2013
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983779495202771

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21 Times Cited - Web of Science