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

Ellen M. Tedaldi*, James T. Richardson, Rachel Debes, Benjamin Young, Joan S. Chmiel, Marcus D. Durham, John T. Brooks, Kate Buchacz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

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/mm3 (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.

Original languageEnglish (US)
Pages (from-to)232-241
Number of pages10
JournalJournal of the International Association of Providers of AIDS Care
Volume13
Issue number3
DOIs
StatePublished - 2014

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Centers for Disease Control and Prevention (contract nos. 200-2001-00133, 200-2006-18797, and 200-2011-41872). Ellen Tedaldi received a research grant from Gilead Sciences. Ben Young is a speaker for Bristol-Myers Squibb, Gilead, Glaxo-Smith Kline, Monogram Sciences, ViiV Health Care, and Merck and has received research support from Glaxo-Smith Kline, Gilead Sciences, ViiV Health Care, BMS, and Merck. Ken Lichtenstein is on the advisory board for Gilead, Boeringer-Ingelheim and is a researcher for Gilead and Abbievie.

Keywords

  • HIV infection
  • antiretroviral adherence
  • retention

ASJC Scopus subject areas

  • Infectious Diseases
  • Dermatology
  • Immunology

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