Assessment of a medical outreach program to improve access to HIV care among marginalized individuals

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 [Cl] = 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% Cl=1.54, 4.17), or when made by nonmedical providers (compared with medical providers; future appointments: AOR = 1.38; 95% Cl = 1.05, 1.80; same-day appointments: AOR = 1.70; 95% Cl = 1.03, 2.81). These findings demonstrate the importance of program-related characteristics in health services delivery to marginalized populations.