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Disparities in among HIV-Infected in the Risk Late Early of Antiretroviral

Background . CD4 counts at entry to care are an important indicator of care engagement among HIV patients. The relationship between geographic, structural, and economic characteristics and HIV care engagement is not well understood. Methods . An exploratory G i * clustering analysis was conducted to visualize the UNC Infectious Disease Clinic patient population, assess geographic clustering of CD4 counts at entry to care, and adjust for covariates. Generalized estimating equations were used to account for patient clustering into census tracts. Bivariate associations were explored, and a final model was fit, including educational attainment as the only community-level covariate. Results . There was significant clustering of high CD4 counts at entry to care in Orange and Durham counties, the counties nearest the UNC Infectious Disease Clinic. African-American, non-Hispanic patients had on average 9 percent lower CD4 counts at care imitation compared to their white counterparts, while Hispanic patients had on average 31 percent lower CD4 counts at care initiation compared to their white peers. A ten percent decrease in educational attainment was significantly associated with a 3.1 percent decrease in CD4 counts at care initiation. Conclusion . Educational individual of health, is associated with CD4 counts at care initiation. Clinicians and public health leaders must be aware of the communities in which patients reside, as well as the risk factors particular to the individual patient, in order to treat the patient holistically.