Differences in the pre- and post-Katrina New Orleans HIV outpatient clinic population: Who has returned?

Background: Hurricane Katrina devastated the New Orleans area and dispersed the patient population of the HIV Outpatient Program (HOP) clinic of the Medical Center of Louisiana at New Orleans (MCLNO). Patients began returning to care following the clinic's reopening in a temporary location in November 2005. Methods: Cross-sectional analyses were performed using existing data from pre-Katrina and at two post-Katrina time points. Adult and adolescent patients receiving HIV primary care at the HOP clinic at any point from the time period March 1, 2005 through April 30, 2006 were included in the analyses. Results: Patients who initially returned were older, had been healthier before the storm, and were more likely to be white and male. Individuals likely incarcerated at the time of the storm showed the lowest return rates. Older age was independently associated with higher rates of return only among females and nonblack males. Living in highly damaged areas was associated with lower return rates only among females and black males, while having higher CD4 counts pre-Katrina was associated with higher return rates in these two groups. Conclusions: These results highlight the need for medical facilities to anticipate changes inpatient populations in the wake of a disaster. Although this work was conducted in an HIV-positive patient population, the results may also apply to patients receiving care for other chronic illnesses.