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AJPH First Look, published online ahead of print Aug 29, 2007
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97/10/1758    most recent
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October 2007, Vol 97, No. 10 | American Journal of Public Health 1758-1761
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2006.090878

FIELD ACTION REPORT

Assessment of a Medical Outreach Program to Improve Access to HIV Care Among Marginalized Individuals

Chinazo O. Cunningham, MD, John Paul Sanchez, MD, MPH, Daliah I. Heller, MPH and Nancy L. Sohler, PhD, MPH

Chinazo O. Cunningham is with the Division of General Internal Medicine and Department of Family and Social Medicine at Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY. John Paul Sanchez is with the Department of Emergency Medicine at Jacobi Medical Center/Montefiore Medical Center, New York. At the time of this analysis, Daliah I. Heller was with CitiWide Harm Reduction, Inc, New York. Nancy L. Sohler is with the Sophie Davis Medical School at the City University of New York and Montefiore Medical Center, New York.

Correspondence: Requests for reprints should be sent to Chinazo O. Cunningham, MD, Montefiore Medical Center, Division of General Internal Medicine, 111 E 210th St, Bronx, NY 10467 (e-mail: ccunning{at}montefiore.org).

Marginalized populations are disproportionately affected by HIV, yet they have poor access to health services. Outreach programs focus on improving access, but few are evaluated. We assessed a medical outreach program targeting unstably housed, HIV-infected individuals. We extracted data from 2003–2005 to examine whether keeping medical appointments was associated with patient and program characteristics.

Patients kept appointments more frequently when they were walk-in or same-day appointments (compared with future appointments; adjusted odds ratio [AOR]=1.69; 95% confidence interval [CI] = 1.38, 2.08), when they were at a community-based organization’s drop-in center (compared with single-room occupancy hotels; AOR=2.50; 95% CI=1.54, 4.17), or when made by nonmedical providers (compared with medical providers; future appointments: AOR = 1.38; 95% CI = 1.05, 1.80; same-day appointments: AOR = 1.70; 95% CI = 1.03, 2.81).

These findings demonstrate the importance of program-related characteristics in health services delivery to marginalized populations.






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Copyright © 2007 by the American Public Health Association