AIDS Awareness Month: Highlighting research from Dr. April Kimmel and her team
Dr. April Kimmel, Associate Professor and primary faculty member of the Healthcare Policy and Research PhD program, leads her team of students and staff to conduct federally-funded, team-based research that informs policy related to HIV and other chronic conditions worldwide. Below are some publications featuring work by PhD students Jessica Kiernan, MSc and Delton Harris, MSW, Postdoctoral Fellow Zhongzhe Pan, PhD, MHS, and Project Coordinator Rose Bono, MPH.
December, 2023
Kiernan JS, Dahman B, Krist A, Neigh G, Kimmel AD, Access to Federally Qualified Health Centers and HIV Outcomes in the US South, American Journal of Preventive Medicine, 2023, ISSN 0749-3797 https://doi.org/10.1016/j.amepre.2023.12.008
This study examines the impact of accessible primary care on population-level HIV outcomes in urban ZIP Code Tabulation Areas across the US South with high rates of new HIV diagnoses. The study found greater access to Federally Qualified Health Centers was associated with fewer percent late HIV diagnoses, greater percent linked to care, and greater percent virally suppressed. Federally Qualified Health Centers may play an important role in the prevention and treatment of HIV.
January, 2023
Pan Z, Dahman B, Bono R, Sabik LM, Belgrave FZ, Yerkes L, Nixon DE, Kimmel AD. Brief Report: Physician Reimbursement and Retention in HIV Care: Racial Disparities in the US South. JAIDS Journal of Acquired Immune Deficiency Syndromes 92(1)p: 1-5, January 1, 2023. DOI: 10.1097/QAI.0000000000003105
Retention in HIV care remains a national challenge. Addressing structural barriers to care may improve retention. This paper examines physician reimbursement as a structural barrier to higher-quality HIV care in the US South, focusing on better retention in HIV care. Utilizing the Medicaid claims data, we found that raising physician reimbursement for Medicaid enrollees will improve their retention in care. This relationship is also found among non-Hispanic black individuals but not among non-Hispanic white individuals, which implies that raising physician reimbursement may help reduce racial disparities in retention in HIV care and promote health equity.
November, 2022
Bono RS, Pan Z, Dahman B, Deng Y, Kimmel AD. Urban-rural disparities in geographic accessibility to care for people living with HIV. AIDS Care. 2023 Dec;35(12):1844-1851. doi: 10.1080/09540121.2022.2141186. Epub 2022 Nov 12. PMID: 36369925; PMCID: PMC10175509.
Compared with people living with HIV in urban areas, those in rural areas travel nearly four times as long to their usual care provider. Using data from 49,596 Medicaid enrollees living with HIV, we estimated enrollee drive time to their usual care provider. For residents of urban counties, median drive time was 12 minutes (interquartile range 21), while residents of rural counties had drive times nearly four times as long (median 44, interquartile range 82 minutes), p<0.0001. Drive times to care exceeded 1 hour for nearly 40% of rural people living with HIV, compared to 12% of urban residents (p<0.0001). These disparities in drive time highlight rural residence as a potential barrier to care for people living with HIV.
November, 2021
Harris D, Kimmel AD, Relationship between gender identity and guide-line concordant HIV testing in the US, Poster, 16th International Conference on HIV Treatment and Prevention Adherence, Orlando FL, 2021.
Using the Behavioral Risk Factor Surveillance System, 2014–19, we examined the relationship between gender identity and guideline-concordant HIV testing among n=9,388 adults engaging in anal sex and at high risk for acquiring HIV. Transgender individuals had lower annual HIV testing compared to cisgender men (adjusted odds ratio 0.52, 95% confidence interval [0.41, 0.65]). Among transmen and transwomen only, there was no statistically significant difference in guideline-concordant HIV testing for transmen compared to transwomen. Improving provider sexual education and establishing service delivery metrics to address gender identity and HIV testing at high risk of HIV acquisition should be immediate HIV prevention priorities.
For more information on our department’s ongoing research projects, visit the Research section of our website at https://hbp.vcu.edu/research/
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