就诊时间而非社区犯罪率与 HIV 阳性患者的护理保留率相关。
Travel Time to Clinic but not Neighborhood Crime Rate is Associated with Retention in Care Among HIV-Positive Patients.
机构信息
Department of Medicine, University of Chicago, 5841 S Maryland Ave, MC 5065, 60637, Chicago, IL, USA.
Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
出版信息
AIDS Behav. 2018 Sep;22(9):3003-3008. doi: 10.1007/s10461-018-2094-5.
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.
利用地理空间分析，我们研究了患者居住地与诊所之间的距离、前往诊所的交通时间以及附近暴力犯罪率与艾滋病毒感染者（PLWH）保持治疗或病毒抑制之间的关系。对于一家大型城市诊所的艾滋病毒阳性患者，我们测量了家庭和诊所之间的距离和旅行时间，以及旅行路线内两个街区半径范围内的暴力犯罪率。使用克鲁斯卡尔-沃利斯等级和检验比较组间结果。在 2008 年至 2016 年的观察期间，219/602（36%）名患者得到了治疗。与未保留治疗的患者相比，保留治疗的患者与诊所的距离中位数为 3.6（IQR 2.1-5.6）英里，中位数为 3.9（IQR 2.7-6.1）英里，p=0.06。保留治疗的患者乘车旅行时间中位数为 15.9（IQR 9.6-22.9）分钟，而未保留治疗的患者为 17.1（IQR 12.0-24.6）分钟，p=0.04。旅行路线上的暴力犯罪率与保留治疗无关。旅行时间或距离与病毒抑制之间没有显著关联。
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