ingest cdrApp 2018-03-15T16:42:01.924Z d591f2cd-3da7-4b31-9dd8-ee27dcb6a3ee modifyDatastreamByValue RELS-EXT fedoraAdmin 2018-03-15T16:42:53.359Z Setting exclusive relation addDatastream MD_TECHNICAL fedoraAdmin 2018-03-15T16:43:04.595Z Adding technical metadata derived by FITS addDatastream MD_FULL_TEXT fedoraAdmin 2018-03-15T16:43:27.861Z Adding full text metadata extracted by Apache Tika modifyDatastreamByValue RELS-EXT fedoraAdmin 2018-03-15T16:43:50.049Z Setting exclusive relation modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-05-17T14:37:15.203Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-11T01:13:22.230Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-07-17T21:19:00.591Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-08T20:37:40.812Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-08-15T17:46:57.106Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-21T18:12:11.619Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-09-26T21:26:27.308Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2018-10-11T22:02:34.407Z modifyDatastreamByValue MD_DESCRIPTIVE cdrApp 2019-03-20T15:34:11.200Z Brettania Lopes Author Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. Winter 2017 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven R. Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation Epidemiology Sonia Napravnik Thesis advisor Steven R. Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text University of North Carolina at Chapel Hill Degree granting institution Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS; Cohort study; HIV; Medical care; Rural; Southeastern United States eng Doctor of Philosophy Dissertation Epidemiology Sonia Napravnik Thesis advisor Steven R. Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text University of North Carolina at Chapel Hill Degree granting institution Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health INITIATION, RETENTION AND SURVIVAL IN HIV CLINICAL CARE: EFFECT OF RESIDENCE Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS, Cohort study, HIV, Medical care, Rural, Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Epidemiology Sonia Napravnik Thesis advisor Steven R. Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Brettania Lopes Creator Department of Epidemiology Gillings School of Global Public Health Late entry to human immunodeficiency virus (HIV) clinical care and inadequate engagement with care are associated with increased morbidity, mortality and secondary HIV transmission. Among HIV-infected persons in the U.S., approximately a quarter are diagnosed with acquired immune deficiency syndrome (AIDS) within 3 months of HIV diagnosis and a third within a year. After patients initiate HIV care, the majority miss clinic visits, 10-35% do not meet the Institute of Medicine’s (IOM) core retention indicator, and 20-50% become lost to follow up (LTFU). In the U.S., rural residence is associated with factors that may affect HIV care such as socioeconomic status, employment, educational level, and access to health insurance. Rural residence has been associated with delayed entry into care and increased mortality among some HIV-infected populations. However, to date little is known about the association between rural patient residence and HIV care retention and survival in the U.S. This study relied on the UNC CFAR HIV Clinical Cohort (UCHCC), a clinical cohort enrolling patients receiving primary HIV care at a large tertiary care facility in the Southeastern U.S. Patient residence was categorized as urban or rural using the United States Department of Agriculture Rural Urban Commuting Area codes (RUCAs). The median CD4 cell count at care entry was compared between patients residing in urban versus rural residences using multivariable linear regression. Poisson, log-binomial and Cox proportional hazards regression were used to estimate the association between residence and the incidence rate of missed visits, IOM indicator and time to loss to follow up (LTFU) and death, respectively. Results revealed the advanced progression of HIV-infection among a sizable group of patients. Rural in comparison to urban residence was associated with a lower likelihood of dropping out of care but was not associated with missed clinic visits or meeting the IOM retention indicator. Rural patients were at greater risk of mortality while in HIV care. This study provides some of the first evidence of the effects of residing in rural areas on HIV care access. Future studies focusing on geographic factors affecting HIV clinical care access and survival while in care are needed. 2017-12 2017 Epidemiology Public health Medicine AIDS; Cohort study; HIV; Medical care; Rural; Southeastern United States eng Doctor of Philosophy Dissertation University of North Carolina at Chapel Hill Graduate School Degree granting institution Sonia Napravnik Thesis advisor Steven R. Meshnick Thesis advisor Joseph Eron Thesis advisor William Miller Thesis advisor Michael Mugavero Thesis advisor text Lopes_unc_0153D_17416.pdf uuid:724aff3a-8771-46bf-9e14-2b62e9f39801 2019-12-31T00:00:00 2017-11-20T16:19:48Z proquest application/pdf 1586959