Multilevel Resilience and Appointment Attendance Among African American/Black Adults with HIV: A Prospective Multisite Cohort Study.

IF 4.7 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiology Pub Date : 2025-01-01 Epub Date: 2024-10-10 DOI:10.1097/EDE.0000000000001801

Marta G Wilson-Barthes, Jee Won Park, Michael J Mugavero, Sonia Napravnik, Michael P Carey, Joseph L Fava, Sannisha K Dale, Valerie A Earnshaw, Deana Agil, Chanelle J Howe, Akilah J Dulin

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Abstract

Background: Attending clinic appointments supports HIV viral suppression, yet racial disparities are documented. We assessed whether multilevel resilience resources were associated with appointment attendance among African American/Black (AA/B) adults living with HIV in the United States.

Methods: We ascertained data from 291 AA/B clinical cohort participants from 2018 to 2021. We assessed resilience using the Multilevel Resilience Resource Measure. Binary outcomes were a nonrepeated indicator of attending ≥87.5% of scheduled HIV appointments over 12 months (i.e., visit adherence) and a repeated measure of attending appointments during two sequential 6-month follow-up windows (i.e., clinic attendance). Modified Poisson models estimated adjusted risk ratios (aRRs).

Results: The aRR for clinic attendance among participants with greater versus lesser multilevel resilience resource endorsement was 0.95 (95% confidence interval: 0.88, 1.0). The aRR for visit adherence among participants with greater versus lesser multilevel resilience resource endorsement was 1.2 (0.95, 1.4).

Conclusions: This analysis is one of the first to assess appointment attendance as a function of resilience. Findings should be confirmed in larger cohorts.

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非裔美国人/黑人成人艾滋病毒感染者的多层面复原力和就诊情况：一项前瞻性多地点队列研究。

背景：到诊所就诊有助于抑制艾滋病病毒，但种族差异是有据可查的。我们评估了美国非裔美国人/黑人（AA/B）成年艾滋病毒感染者的多层次复原力资源是否与预约就诊相关：我们确定了 2018 年至 2021 年期间 291 名 AA/B 临床队列参与者的数据。我们使用多层次复原力资源测量法评估复原力。二元结果是一个非重复指标，即在 12 个月内参加≥87.5% 的艾滋病毒预约（即就诊依从性），以及一个重复指标，即在两个连续 6 个月的随访窗口期间参加预约（即门诊出勤率）。修正的泊松模型估算了调整风险比（aRR）：多层次复原力资源认可度较高与较低的参与者就诊率的 aRR 为 0.95（95% 置信区间：0.88, 1.0）。多层次复原力资源认可度较高与较低的参与者坚持就诊的 aRR 为 1.2 (0.95, 1.4)：这项分析是首次将就诊率作为抗逆力的一项功能进行评估的分析之一。研究结果应在更大规模的队列中得到证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.70

自引率

3.70%

发文量

177

审稿时长

6-12 weeks

期刊介绍： Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.