Skip to main content

Advertisement

SpringerLink
Log in

Comparing Different Measures of Retention in Care Among a Cohort of Adolescents and Young Adults Living with Behaviorally-Acquired HIV

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Young people living with HIV (YLWH) have some of the lowest rates of retention in HIV care, putting them at risk for negative health outcomes. To better understand retention in care in this age group, we conducted a retrospective cohort analysis of YLWH initiating care at a multidisciplinary, adolescent-focused HIV clinic (N = 344). Retention was calculated using a variety of definitions, and relationships between different definitions were assessed. During the 1-year study period, on average YLWH missed two scheduled appointments, and attended 80% of appointments, usually at least once every 3 months. About one-quarter experienced a 6-month gap in care and about two-thirds met the Health Resources and Services Administration’s retention criteria. Although most retention definitions were significantly correlated, not all were. Researchers, clinicians, and policymakers should consider the impact of varying definitions of retention, in order to optimally measure this outcome in YLWH, a key vulnerable population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800.

    PubMed  PubMed Central  Google Scholar 

  2. Rebeiro P, Althoff KN, Buchacz K, Gill MJ, Horberg M, Krentz H, et al. Retention among North American HIV–infected persons in clinical care, 2000–2008. JAIDS. 2013;62(3):356–62.

    PubMed  Google Scholar 

  3. Mugavero MJ, Amico KR, Horn T, Thompson MA. The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis. 2013;57(8):1164–71.

    Article  PubMed  Google Scholar 

  4. Mugavero MJ, Davila JA, Nevin CR, Giordano TP. From access to engagement: measuring retention in outpatient HIV clinical care. AIDS Patient Care ST. 2010;24(10):607–13.

    Article  Google Scholar 

  5. Centers for Disease Control and Prevention. HIV continuum of care, U.S., 2014, overall and by age, race/ethnicity, transmission route and sex. https://www.cdc.gov/nchhstp/newsroom/2017/HIV-Continuum-of-Care.html. Retrieved 7 Oct 2018

  6. Minniear TD, Gaur AH, Thridandapani A, Sinnock C, Tolley EA, Flynn PM. Delayed entry into and failure to remain in HIV care among HIV-infected adolescents. AIDS Res Hum Retrovir. 2013;29(1):99–104.

    Article  PubMed  Google Scholar 

  7. Zanoni BC, Mayer KH. The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities. AIDS Patient Care ST. 2014;28(3):128–35.

    Article  Google Scholar 

  8. Morales-Alemán MM, Opoku J, Murray A, Lanier Y, Kharfen M, Sutton MY. Disparities in retention in HIV care among HIV-infected young men who have sex with men in the District of Columbia, 2013. LGBT Health. 2017;4(1):34–41.

    Article  PubMed  Google Scholar 

  9. Ryscavage PA, Anderson EJ, Sutton SH, Reddy S, Taiwo B. Clinical outcomes of adolescents and young adults in adult HIV care. JAIDS. 2011;58(2):193–7.

    PubMed  Google Scholar 

  10. Magnus M, Jones K, Phillips G, Binson D, Hightow-Weidman LB, Richards-Clarke C, Wohl AR, Outlaw A, Giordano TP, Quamina A, Cobbs W. Characteristics associated with retention among African American and Latino adolescent HIV-positive men: results from the outreach, care, and prevention to engage HIV-seropositive young MSM of color special project of national significance initiative. JAIDS. 2010;53(4):529–36.

    PubMed  Google Scholar 

  11. Outlaw A, Naar-King S, Green-Jones M, Wright K, Condon K, Sherry L, Janisse H. Brief report: predictors of optimal HIV appointment adherence in minority youth: a prospective study. J Pediatr Psychol. 2010;35(9):1011–5.

    Article  PubMed  Google Scholar 

  12. Palar K, Wong MD, Cunningham WE. Competing subsistence needs are associated with retention in care and detectable viral load among people living with HIV. J HIV/AIDS Soc Serv. 2018;31:1–7.

    Google Scholar 

  13. Wood SM, Lowenthal E, Lee S, Ratcliffe SJ, Dowshen N. Longitudinal viral suppression among a cohort of adolescents and young adults with behaviorally acquired human immunodeficiency virus. AIDS Patient Care ST. 2017;31(9):377–83.

    Article  Google Scholar 

  14. Wood S, Ratcliffe S, Gowda C, Lee S, Dowshen NL, Gross R. Impact of insurance coverage on HIV transmission potential among antiretroviral therapy-treated youth living with HIV. AIDS. 2018;32(7):895–902.

    PubMed  Google Scholar 

  15. Lazar NR, Salas-Humara C, Wood S, Mollen C, Dowshen N. Missed opportunities for HIV screening prior to diagnosis among a cohort of youth living with HIV. J Adolesc Health. 2018;62(2):S21.

    Article  Google Scholar 

  16. Fleishman JA, Yehia BR, Moore RD, Korthuis PT, Gebo KA, HIV Research Network. Establishment, retention, and loss to follow-up in outpatient HIV care. JAIDS. 2012;60(3):249–59.

    PubMed  Google Scholar 

  17. Tanner Z, Lachowsky N, Ding E, Samji H, Hull M, Cescon A, Patterson S, Chia J, Leslie A, Raboud J, Loutfy M. Predictors of viral suppression and rebound among HIV-positive men who have sex with men in a large multi-site Canadian cohort. BMC Infect Dis. 2016;16(1):590–601.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chen PY, Popovich PM. Correlation: parametric and nonparametric measures. Thousand Oaks: Sage Publications; 2002.

    Book  Google Scholar 

  19. Hall HI, Gray KM, Tang T, Li J, Shouse L, Mermin J. Retention in care of adults and adolescents living with HIV in 13 US areas. JAIDS. 2012;60(1):77–82.

    PubMed  Google Scholar 

  20. Rebeiro PF, Horberg MA, Gange SJ, Gebo KA, Yehia BR, Brooks JT, Buchacz K, Silverberg MJ, Gill J, Moore RD, Althoff KN. Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services. PLoS ONE. 2014;9(11):e111772.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Horstmann E, Brown J, Islam F, Buck J, Agins BD. Retaining HIV-infected patients in care: where are we? Where do we go from here? Clin Infect Dis. 2010;50(5):752–61.

    PubMed  Google Scholar 

  22. Crawford TN, Sanderson WT, Thornton A. A comparison study of methods for measuring retention in HIV medical care. AIDS Behav. 2013;17(9):3145–51.

    Article  PubMed  Google Scholar 

  23. Yehia BR, Fleishman JA, Metlay JP, Korthuis PT, Agwu AL, Berry SA, Moore RD. Comparing different measures of retention in outpatient HIV care. AIDS. 2012;26(9):1131.

    Article  PubMed  Google Scholar 

  24. Mugavero MJ, Westfall AO, Zinski A, Davila J, Drainoni ML, Gardner LI, Keruly JC, Malitz F, Marks G, Metsch L, Wilson TE. Measuring retention in HIV care: the elusive gold standard. JAIDS. 2012;61(5):574.

    PubMed  Google Scholar 

  25. Reveles KR, Juday TR, Labreche MJ, Mortensen EM, Koeller JM, Seekins D, Oramasionwu CU, Bollinger M, Copeland LA, Jones X, Frei CR. Comparative value of four measures of retention in expert care in predicting clinical outcomes and health care utilization in HIV patients. PLoS ONE. 2015;10(3):e0120953.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This research was directly supported by grants from F32 MH111341 (PI: S.M.W.), K23 MH102128 (PI: N.D.). This research was also made possible through core services and support from the Penn Center for AIDS Research (CFAR), an NIH-funded program (P30 AI 045008). The authors thank Susan Lee for her invaluable assistance with this project.

Author information

Authors and Affiliations

  1. Division of Adolescent and Young Adult Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Caitlin S. Sayegh & Marvin Belzer

  2. Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Caitlin S. Sayegh & Marvin Belzer

  3. Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Sarah M. Wood & Nadia L. Dowshen

  4. Craig-Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Sarah M. Wood & Nadia L. Dowshen

Authors
  1. Caitlin S. Sayegh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah M. Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marvin Belzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nadia L. Dowshen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Caitlin S. Sayegh.

Ethics declarations

Conflict of interest

All authors declare they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The institutional review board overseeing this study provided a waiver of informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sayegh, C.S., Wood, S.M., Belzer, M. et al. Comparing Different Measures of Retention in Care Among a Cohort of Adolescents and Young Adults Living with Behaviorally-Acquired HIV. AIDS Behav 24, 304–310 (2020). https://doi.org/10.1007/s10461-019-02568-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02568-8

Keywords

Search

Navigation