All ETDs from UAB

Advisory Committee Chair

Dustin Long

Advisory Committee Members

Stacy Cofield

Henna Budhwani

Michael Mugavero

Jeff Szychowski

Document Type

Dissertation

Date of Award

2023

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. Reducing the risk of missed visits directly contributes to improving retention in care and overall health for PWH. This dissertation aims to investigate the risk factors associated with missed prima-ry care visits among PWH. The first paper presents a systematic review summarizing re-ported risk factors for missed HIV visits in studies conducted between 2000 and 2022. The second paper focuses on youth with HIV (YWH), a vulnerable subpopulation of PWH, exploring the specific risk factors associated with missed visits in this group. The final paper develops a predictive model using machine learning algorithms for new-to-care patients, leveraging advanced statistical techniques to predict missed visits with limited patient information. Through a combination of methodologies, this dissertation provides a comprehensive understanding of the risk factors associated with missed visits among PWH. The iv findings contribute to the existing knowledge base and offer insights into improving retention in HIV care. By identifying and addressing the factors influencing missed visits, healthcare providers and policymakers can develop targeted interventions to enhance retention in care and ultimately improve the health outcomes of PWH.

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