Multilevel Resilience and Appointment Attendance Among African American/Black Adults with HIV: A Prospective Multisite Cohort Study

Background: Attending clinic appointments supports HIV viral suppression, yet racial disparities are documented. We assessed whether multilevel resilience resources were associated with appointment attendance among African American/Black (AA/B) adults living with HIV in the United States. Methods: We ascertained data from 291 AA/B clinical cohort participants from 2018 to 2021. We assessed resilience using the Multilevel Resilience Resource Measure. Binary outcomes were a nonrepeated indicator of attending ≥87.5% of scheduled HIV appointments over 12 months (i.e., visit adherence) and a repeated measure of attending appointments during two sequential 6-month follow-up windows (i.e., clinic attendance). Modified Poisson models estimated adjusted risk ratios (aRRs). Results: The aRR for clinic attendance among participants with greater versus lesser multilevel resilience resource endorsement was 0.95 (95% confidence interval: 0.88, 1.0). The aRR for visit adherence among participants with greater versus lesser multilevel resilience resource endorsement was 1.2 (0.95, 1.4). Conclusions: This analysis is one of the first to assess appointment attendance as a function of resilience. Findings should be confirmed in larger cohorts.