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High retention in HIV care at a tertiary care centre in Toronto, Canada.
- Source :
-
AIDS Care . Feb2018, Vol. 30 Issue 2, p246-254. 9p. 1 Diagram, 5 Charts. - Publication Year :
- 2018
-
Abstract
- Poor retention in HIV care is associated with poor clinical outcomes and mortality. Previous studies of predictors of poor retention have been conducted with a wide variety of populations, using different measures of retention, and occasionally have conflicting results. We studied demographic and psychosocial factors associated with inter-visit interval length in a setting of universal health care and modern cART. Patients attending ≥2 appointments with an HIV specialist at the Toronto General Hospital Immunodeficiency Clinic from 2004 to 2013 were studied. A sub-analysis included psychosocial measures from annual questionnaires for Ontario HIV Treatment Network Cohort Study (OCS) participants. Median inter-visit interval and constancy (percentage of 4-month intervals with ≥1 visit) were calculated by patient. Multivariable generalized estimating equation models identified factors associated with inter-visit interval length and intervals ≥12 months. 1591 patients were included. 615 patients completed an OCS questionnaire and were more likely to be older white MSM from Canada with a viral load (VL) <50 copies/ml. The median (IQR) of patients’ median inter-visit intervals was 3.15 (2.78, 3.84) months and median (IQR) constancy was 90% (71%, 100%). Two percent of inter-visit intervals were ≥12 months and 25% of patients had ≥1 interval ≥12 months. Longer inter-visit intervals were associated with younger age, white race, earlier calendar year, longer duration of HIV, VL < 50 copies/mL and higher CD4 counts. Patients who were younger, white, had injection drug use as a risk factor, had a longer duration of HIV, and had VL ≥50 copies/mL were more likely to have an inter-visit interval ≥12 months. In the OCS sub-analysis including psychosocial variables, lower levels of depression were associated with longer inter-visit intervals. Retention at this tertiary care centre was high. Efforts to maximize attendance should focus on younger patients and those with substance abuse issues. [ABSTRACT FROM PUBLISHER]
- Subjects :
- *AGE distribution
*MENTAL depression
*DRUGS of abuse
*PSYCHOLOGY of HIV-positive persons
*MULTIVARIATE analysis
*PATIENT compliance
*QUESTIONNAIRES
*RACE
*SAMPLE size (Statistics)
*VIRAL load
*INTRAVENOUS drug abusers
*PATIENT dropouts
*DISEASE duration
*DATA analysis software
*DESCRIPTIVE statistics
*CD4 lymphocyte count
*TERTIARY care
Subjects
Details
- Language :
- English
- ISSN :
- 09540121
- Volume :
- 30
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- AIDS Care
- Publication Type :
- Academic Journal
- Accession number :
- 126669584
- Full Text :
- https://doi.org/10.1080/09540121.2017.1349278