ArticleJournal of acquired immune deficiency syndromes (1999)2017
HIV Care Initiation Delay Among Rural Residents in the Southeastern United States, 1996 to 2012.
Article in Journal of acquired immune deficiency syndromes (1999), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Acceptability, Feasibility, and Preliminary Impact of 4 Remotely-Delivered Interventions for Rural Older Adults Living with HIV.AIDS and behavior · 2024Trial
- Does travel time matter?: predictors of transportation vulnerability and access to HIV care among people living with HIV in South Carolina.BMC public health · 2025Article
- Telehealth Challenges, Opportunities, and Policy Recommendations for Rural Older Adults Living with HIV in the United States.Journal of aging & social policy · 2025Article
- Food Insecurity Prevalence and Risk Factors among Persons with HIV in a Southeastern US Clinical Care Setting.AIDS and behavior · 2025Article
- Predictors of CD4 cell count progression over time among adolescents and young adults transitioning to adult-oriented HIV care in Southern Ethiopia from 2017 to 2021: a retrospective cohort study.BMC public health · 2024Article
- Urban-rural disparities in geographic accessibility to care for people living with HIV.AIDS care · 2023Article
- Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Challenges to meeting the HIV care needs of older adults in the rural South.SSM. Qualitative research in health · 2022Article
- Transportation Barriers and Health-Related Quality of Life in a Sample of Middle-Aged and Older Adults Living with HIV in the Deep South.AIDS and behavior · 2022Article
- Article
- Human Immunodeficiency Virus-Experienced Clinician Workforce Capacity: Urban-Rural Disparities in the Southern United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Associations between population density and clinical and sociodemographic factors in women living with HIV in the Southern United States.AIDS care · 2021Article
- Article
- Implementation of an Immediate HIV Treatment Initiation Program in a Public/Academic Medical Center in the U.S. South: The Miami Test and Treat Rapid Response Program.AIDS and behavior · 2019Article
- Assessing Differences in CDC-Funded HIV Testing by Urbanicity, United States, 2016.Journal of community health · 2019Article
- Repeat Human Immunodeficiency Virus Testing by Transmission Risk Group and Rurality of Residence in North Carolina.Sexually transmitted diseases · 2018Article
- Washington state satellite HIV clinic program: a model for delivering highly effective decentralized care in under-resourced communities.AIDS care · 2018Article
- HIV Testing, Linkage to HIV Medical Care, and Interviews for Partner Services Among Black Men Who Have Sex with Men - Non-Health Care Facilities, 20 Southern U.S. Jurisdictions, 2016.MMWR. Morbidity and mortality weekly report · 2018Article
- Challenges Facing a Rural Opioid Epidemic: Treatment and Prevention of HIV and Hepatitis C.Current HIV/AIDS reports · 2018Review
- Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundDelaying HIV care initiation may lead to greater morbidity, mortality, and further HIV transmission. Rural residence may be associated with delayed diagnosis and linkage to care, with negative clinical outcomes.
objectiveTo examine the association between rural patient residence and CD4 cell count at HIV care initiation in a large HIV clinical cohort in the Southeastern United States.
methodsWe included HIV-infected patients who initiated care between 1996 and 2012 with a geocodable address and no previous history of HIV clinical care. Patient residence was categorized as urban or rural using United States Department of Agriculture Rural Urban Commuting Area codes. Multivariable linear regression models were fit to estimate the association between patient residence and CD4 cell count at HIV care initiation.
resultsAmong 1396 patients who met study inclusion criteria, 988 had a geocodable address. Overall, 35% of patients resided in rural areas and presented to HIV care with a mean CD4 cell count of 351 cells/mm (SD, 290). Care initiation mean CD4 cell counts increased from 329 cells/mm (SD, 283) in 1996-2003 to 391 cells/mm (SD, 292) in 2008-2012 (P = 0.006). Rural in comparison with urban patients presented with lower CD4 cell counts with an unadjusted and adjusted mean difference of -48 cells/mm [95% confidence interval, -86 to -10) and -37 cells/mm (95% confidence interval: -73 to -2), respectively, consistently observed across calendar years.
conclusionsHIV care initiation at low CD4 cell counts was common in this Southeastern US cohort and more common among rural area residents.
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