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Risk and Protective Factors for Retention in HIV Care

Abstract

Retention in care for HIV is essential for effective disease management; however, factors that may confer risk or protection for adherence to regular HIV care are less well understood. This study tested whether HIV-associated cognitive impairment (CI) and low health literacy reduced adherence to routine HIV medical and phlebotomy visits and if social support and patient-provider relationship conferred a protective effect. Participants were 210 HIV-infected patients enrolled in outpatient care and followed for 28-weeks. Results showed that those attending >75 % of phlebotomy visits were more likely to be virally suppressed. Health literacy was unassociated with adherence to medical or phlebotomy visits. CI was not directly related to medical or phlebotomy visit adherence; however those with CI and greater use of social support were less likely to miss medical visits. Utilizing social support may be an effective means of managing visit adherence, especially among patients with CI.

Resumen

La retención en el cuidado médico del VIH es esencial para la gestión eficaz de la enfermedad, sin embargo, los factores que pueden conferir riesgo o protección para la adhesión al cuidado médico regular del VIH son menos conocidos. Este estudio examinó si el deterioro cognitivo asociado al VIH y la poca competencia en la utilización de información sobre la salud redujeron la adhesión a cuidado médico de rutina y usos de servicios de laboratorios asociados al VIH, y si el apoyo social y la relación paciente-proveedor otorgaban un efecto de protección. Los participantes fueron 210 pacientes infectados con VIH inscritos en atención ambulatoria y seguidos durante 28 semanas. Los resultados mostraron que los participantes que atendieron >75 % de las citas de laboratorio eran más propensos a tener una carga viral del VIH indetectable.

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Acknowledgments

This study was funded by R21 MH084814.

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Correspondence to Drenna Waldrop-Valverde.

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Waldrop-Valverde, D., Guo, Y., Ownby, R.L. et al. Risk and Protective Factors for Retention in HIV Care. AIDS Behav 18, 1483–1491 (2014). https://doi.org/10.1007/s10461-013-0633-7

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  • DOI: https://doi.org/10.1007/s10461-013-0633-7

Keywords

  • Retention in care
  • Neurocognition
  • Health literacy
  • HAND
  • Visit adherence