@article {1724, title = {Rural Residence and Adoption of a Novel HIV Therapy in a National, Equal-Access Healthcare System.}, journal = {AIDS and behavior}, year = {2011}, month = {2011 Dec 29}, abstract = {Rural persons with HIV face barriers to care that may influence adoption of advances in therapy. We performed a retrospective cohort study to determine rural-urban variation in adoption of raltegravir-the first HIV integrase inhibitor-in national Veterans Afffairs (VA) healthcare. There were 1,222 veterans with clinical indication for raltegravir therapy at time of its FDA approval in October 2007, of whom 223 (19.1\%) resided in rural areas. Urban persons were more likely than rural to initiate raltegravir within 180~days (17.3\% vs. 11.2\%, P~=~0.02) and 360~days (27.5\% vs. 19.7\%, P~=~0.02), but this gap narrowed slightly at 720~days (36.3\% vs. 31.8\%, P~=~0.19). In multivariable analysis adjusting for patient characteristics, urban residence predicted raltegravir adoption within 180~days (odds ratio 1.72, 95\% CI 1.09-2.70) and 360~days (OR 1.63, 95\% CI 1.13-2.34), but not 720~days (OR 1.26, 95\% CI 0.84-1.87). Efforts are needed to reduce geographic variation in adoption of advances in HIV therapy.}, issn = {1573-3254}, doi = {10.1111/j.1530-0277.2011.01601.x}, author = {Ohl, Michael and Lund, Brian and Belperio, Pamela S and Goetz, Matthew Bidwell and Rimland, David and Richardson, Kelly and Justice, Amy and Perencevich, Eli and Vaughan-Sarrazin, Mary} }