Retention in care within 1 year of initial HIV care visit in a multisite US cohort: who's in and who's out?

J Int Assoc Provid AIDS Care. 2014 May-Jun;13(3):232-41. doi: 10.1177/2325957413514631. Epub 2014 Feb 3.

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.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Anti-Retroviral Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology*
  • Humans
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance*
  • Prospective Studies
  • Racial Groups / statistics & numerical data
  • United States

Substances

  • Anti-Retroviral Agents