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Rural AIDS diagnoses in Florida: changing demographics and factors associated with survival

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dc.contributor.authorTrepka, M.J.
dc.contributor.authorNiyonsenga, T.
dc.contributor.authorMaddox, L.M.
dc.contributor.authorLieb, S.
dc.date.issued2013
dc.descriptionLink to a related website: http://europepmc.org/articles/pmc3695411?pdf=render, Open Access via Unpaywall
dc.description.abstractPurpose: To compare demographic characteristics and predictors of survival of rural residents diagnosed with acquired immunodeficiency syndrome (AIDS) with those of urban residents. Methods: Florida surveillance data for people diagnosed with AIDS during 1993-2007 were merged with 2000 Census data using ZIP code tabulation areas (ZCTAs). Rural status was classified based on the ZCTA's rural-urban commuting area classification. Survival rates were compared between rural and urban areas using survival curves and Cox proportional hazards models controlling for demographic, clinical, and area-level socioeconomic and health care access factors. Findings: Of the 73,590 people diagnosed with AIDS, 1,991 (2.7%) resided in rural areas. People in the most recent rural cohorts were more likely than those in earlier cohorts to be female, non-Hispanic black, older, and have a reported transmission mode of heterosexual sex. There were no statistically significant differences in the 3-, 5-, or 10-year survival rates between rural and urban residents. Older age at the time of diagnosis, diagnosis during the 1993-1995 period, other/unknown transmission mode, and lower CD4 count/percent categories were associated with lower survival in both rural and urban areas. In urban areas only, being non-Hispanic black or Hispanic, being US born, more poverty, less community social support, and lower physician density were also associated with lower survival. Conclusions: In rural Florida, the demographic characteristics of people diagnosed with AIDS have been changing, which may necessitate modifications in the delivery of AIDS-related services. Rural residents diagnosed with AIDS did not have a significant survival disadvantage relative to urban residents.
dc.identifier.citationJournal of Rural Health, 2013; 29(3):266-280
dc.identifier.doi10.1111/j.1748-0361.2012.00449.x
dc.identifier.issn0890-765X
dc.identifier.issn1748-0361
dc.identifier.urihttps://hdl.handle.net/11541.2/120828
dc.language.isoen
dc.publisherWiley-Blackwell
dc.relation.fundingNational Institute on Minority Health and Health Disparities at the National Institutes of Health R01MD004002
dc.rightsCopyright 2013 National Rural Health Association
dc.source.urihttps://doi.org/10.1111/j.1748-0361.2012.00449.x
dc.subjectaccess to care
dc.subjectAIDS
dc.subjectmortality
dc.subjectrural health
dc.subjectrural population
dc.titleRural AIDS diagnoses in Florida: changing demographics and factors associated with survival
dc.typeJournal article
pubs.publication-statusPublished
ror.mmsid9916027175601831

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