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The Effect of Initial Patient Experiences and Life Stressors on Predicting Lost to Follow-Up in Patients New to an HIV Clinic


We conducted a prospective cohort study of 450 patients new to an HIV clinic in Houston, TX, to examine the roles of life stressors and initial care experiences in predicting being lost to follow-up in the first year of care. Patients completed a self-administered survey following their initial provider visit. In logistic regression models, patients who reported better experiences with the HIV provider at the first visit were less likely to be lost to follow-up at 6 months (aOR = 0.866, p = 0.038) and 12 months (aOR = 0.825, p = 0.008). Patients with a higher burden of stressful life events were more likely to be lost to follow-up at 6 months (aOR = 1.232, p = 0.037) and 12 months (aOR = 1.263, p = 0.029). Assessments of patient experience and life stressors at the initial visit have potential to predict patients at risk of dropping out of care.

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Data available on request to the authors.


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This study was partly supported by use of the facilities and resources of the Houston VA Center for Innovations in Quality, Effectiveness and Safety (CIN13-413) and Harris Health System. Dr. Dang is supported by a K23 grant funded by the National Institute of Mental Health—1 K23 MH100965-01A1. Thomas P. Giordano is supported by The University of Texas M.D. Anderson Foundation Chair at Baylor College of Medicine. The opinions expressed are those of the authors and not necessarily those of the Department of Veterans Affairs, the US government, or Baylor College of Medicine.

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All authors contributed to the writing of this manuscript. BD, RW and TG conceived and designed the study. BD and SNM collected the data. WB analyzed the data. BD, RW, TG and EG interpreted the data. EG wrote the first draft of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Emmanuel Guajardo.

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Guajardo, E., Giordano, T.P., Westbrook, R.A. et al. The Effect of Initial Patient Experiences and Life Stressors on Predicting Lost to Follow-Up in Patients New to an HIV Clinic. AIDS Behav 26, 1880–1891 (2022).

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  • HIV
  • Patient experience
  • Life stress
  • Retention in care
  • Lost to follow-up