Retention in care within 1 year of initial HIV care visit in a multisite US cohort: who's in and who's out?
- PMID: 24493009
- PMCID: PMC4657738
- DOI: 10.1177/2325957413514631
Retention in care within 1 year of initial HIV care visit in a multisite US cohort: who's in and who's out?
Abstract
Biannual attendance at medical visits is an established measure of retention in HIV care. We examined factors associated with attending at least 2 clinic visits at least 90 days apart among HIV-infected, antiretroviral therapy (ART)-naive HIV Outpatient Study participants entering care during 2000 to 2011. Of 1441 patients, 85% were retained in care during the first year of observation. Starting ART during the year was the strongest correlate of retention (adjusted odds ratio [aOR] 6.4, 95% confidence interval [CI] 4.4-9.4). After adjusting for starting ART, publicly insured patients (aOR 0.6, 95% CI 0.4-1.0), and patients with baseline CD4 counts <200 cells/mm(3) (aOR 0.5, 95% CI 0.3-0.9) or missing CD4 counts (aOR 0.3, 95% CI 0.2-0.6) were less likely to be retained in care. Although most patients had recommended biannual care visits, some ART-naive individuals may require additional interventions to remain in care. Promptly initiating ART may facilitate engagement in care.
Keywords: HIV infection; antiretroviral adherence; retention.
Conflict of interest statement
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The findings and conclusions of this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Similar articles
-
Regular clinic attendance in two large San Francisco HIV primary care settings.AIDS Care. 2016;28(5):579-84. doi: 10.1080/09540121.2015.1118431. Epub 2015 Dec 11. AIDS Care. 2016. PMID: 26654093
-
HIV status and participation in HIV surveillance in the era of antiretroviral treatment: a study of linked population-based and clinical data in rural South Africa.Trop Med Int Health. 2012 Aug;17(8):e103-10. doi: 10.1111/j.1365-3156.2012.02928.x. Trop Med Int Health. 2012. PMID: 22943374 Free PMC article.
-
Retention in HIV care for individuals not yet eligible for antiretroviral therapy: rural KwaZulu-Natal, South Africa.J Acquir Immune Defic Syndr. 2011 Mar 1;56(3):e79-86. doi: 10.1097/QAI.0b013e3182075ae2. J Acquir Immune Defic Syndr. 2011. PMID: 21157360 Free PMC article.
-
Assessing Antiretroviral Use During Gaps in HIV Primary Care Using Multisite Medicaid Claims and Clinical Data.J Acquir Immune Defic Syndr. 2017 Sep 1;76(1):82-89. doi: 10.1097/QAI.0000000000001469. J Acquir Immune Defic Syndr. 2017. PMID: 28797023 Free PMC article.
-
Program-level and contextual-level determinants of low-median CD4+ cell count in cohorts of persons initiating ART in eight sub-Saharan African countries.AIDS. 2011 Jul 31;25(12):1523-33. doi: 10.1097/QAD.0b013e32834811b2. AIDS. 2011. PMID: 21750418 Free PMC article.
Cited by
-
Predictors of Adult Retention in HIV Care: A Systematic Review.AIDS Behav. 2018 Mar;22(3):752-764. doi: 10.1007/s10461-016-1644-y. AIDS Behav. 2018. PMID: 27990582 Free PMC article.
-
Influence of model assumptions about HIV disease progression after initiating or stopping treatment on estimates of infections and deaths averted by scaling up antiretroviral therapy.PLoS One. 2018 Mar 19;13(3):e0194220. doi: 10.1371/journal.pone.0194220. eCollection 2018. PLoS One. 2018. PMID: 29554136 Free PMC article.
-
Disparities in HIV Viral Load Suppression by Race/Ethnicity Among Men Who Have Sex with Men in the HIV Outpatient Study.AIDS Res Hum Retroviruses. 2018 Apr;34(4):357-364. doi: 10.1089/AID.2017.0162. Epub 2018 Feb 13. AIDS Res Hum Retroviruses. 2018. PMID: 29316797 Free PMC article.
-
Beyond binary retention in HIV care: predictors of the dynamic processes of patient engagement, disengagement, and re-entry into care in a US clinical cohort.AIDS. 2018 Sep 24;32(15):2217-2225. doi: 10.1097/QAD.0000000000001936. AIDS. 2018. PMID: 30005018 Free PMC article.
-
Pain is Associated with Missed Clinic Visits Among HIV-Positive Women.AIDS Behav. 2017 Jun;21(6):1782-1790. doi: 10.1007/s10461-016-1475-x. AIDS Behav. 2017. PMID: 27388160 Free PMC article.
References
-
- Office of National HIV/AIDS Policy. [Accessed October 25, 2013];National HIV/AIDS strategy for the United States. http://www.whitehouse.gov/administration/eop/onap/nhas/
-
- Giordano TP, Gifford AL, White AC, Jr, et al. Retention in care: a challenge to survival with HIV infection. Clin Infect Dis. 2007;44(11):1493–1499. - PubMed
-
- Tripathi A, Youmans E, Gibson JJ, Duffus WA. The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study. AIDS Res Hum Retro-viruses. 2011;27(7):751–758. - PubMed
-
- Berg M, Safren S, Mimiaga M, Grasso C, Boswell S, Mayer K. Nonadherence to medical appointments is associated with increased plasma HIV RNA and decreased CD4 cell counts in a community-based HIV primary care clinic. AIDS Care. 2007;17(7):902–907. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials