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A Comparison Study of Methods for Measuring Retention in HIV Medical Care

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Abstract

The purpose of this study was to compare multiple measures of retention in HIV medical care by determining their ability to predict viral suppression. Patients who sought care between 2003 and 2011 were eligible. Visit constancy, gaps-in-care, and HRSA measure were the measures compared. Multiple logistic regressions and area under the curve statistics were employed to determine which measure most accurately discerned between patients with or without viral suppression. There were 850 patients included in the study. The mean follow-up time among the cohort was 5.6 years and less than half were consistently retained in care. All three measures had similar area under the curves, but only visit constancy and gaps in care were significantly associated with viral suppression. Retention in care should be defined consistently across studies and interventions should be set in place to increase the number of optimal retainers.

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References

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

    Article  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. Centers for Disease C Prevention. Vital signs: hIV prevention through care and treatment–United States. MMWR Morb Mortal Wkly Rep. 2011;60(47):1618–23.

    Google Scholar 

  4. Metsch LR, Pereyra M, Messinger S, Del Rio C, Strathdee SA, Anderson-Mahoney P, et al. HIV transmission risk behaviors among HIV-infected persons who are successfully linked to care. Clin Infect Dis. 2008;47(4):577–84.

    Article  PubMed  Google Scholar 

  5. Giordano TP, Hartman C, Gifford AL, Backus LI, Morgan RO. Predictors of retention in HIV care among a national cohort of US veterans. HIV Clin Trials. 2009;10(5):299–305.

    Article  PubMed  Google Scholar 

  6. Mugavero MJ, Amico KR, Westfall AO, Crane HM, Zinski A, Willig JH, et al. Early retention in HIV care and viral load suppression: implications for a test and treat approach to HIV prevention. J Acquir Immune Defic Syndr. 2012;59(1):86–93.

    Article  PubMed  Google Scholar 

  7. Park WB, Choe PG, Kim SH, Jo JH, Bang JH, Kim HB, et al. One-year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients. J Intern Med. 2007;261(3):268–75.

    Article  PubMed  CAS  Google Scholar 

  8. Aberg JA, Kaplan JE, Libman H, Emmanuel P, Anderson JR, Stone VE, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(5):651–81.

    Article  PubMed  Google Scholar 

  9. Kerr T, Walsh J, Lloyd-Smith E, Wood E. Measuring adherence to highly active antiretroviral therapy: implications for research and practice. Curr HIV/AIDS Rep. 2005;2(4):200–5.

    Article  PubMed  Google Scholar 

  10. Chesney M. Adherence to HAART regimens. AIDS Patient Care STDS. 2003;17(4):169–77.

    Article  PubMed  Google Scholar 

  11. Marks G, Gardner LI, Craw J, Crepaz N. Entry and retention in medical care among HIV-diagnosed persons: a meta-analysis. AIDS. 2010;24(17):2665–78.

    Article  PubMed  Google Scholar 

  12. 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 

  13. Mugavero MJ, Westfall AO, Zinski A, Davila J, Drainoni ML, Gardner LI, et al. Measuring retention in HIV care: the elusive gold standard. J Acquir Immune Defic Syndr. 2012;61(5):574–80.

    Article  PubMed  Google Scholar 

  14. Giordano TP, Gifford AL, White AC Jr, Suarez-Almazor ME, Rabeneck L, Hartman C, et al. Retention in care: a challenge to survival with HIV infection. Clin Infect Dis. 2007;44(11):1493–9.

    Article  PubMed  Google Scholar 

  15. Tripathi A, Youmans E, Gibson JJ, Duffus WA. The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study. AIDS Res Hum Retroviruses. 2011;27(7):751–8.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  17. 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. J Acquir Immune Defic Syndr. 2012;60(1):77–82.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed 31 Dec 2011.

  20. Liu H, Golin CE, Miller LG, Hays RD, Beck CK, Sanandaji S, et al. A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001;134(10):968–77.

    Article  PubMed  CAS  Google Scholar 

  21. Mugavero MJ, Lin HY, Allison JJ, Giordano TP, Willig JH, Raper JL, et al. Racial disparities in HIV virologic failure: do missed visits matter? J Acquir Immune Defic Syndr. 2009;50(1):100–8.

    Article  PubMed  Google Scholar 

  22. Agresti A. Categorical data analysis. 2nd ed. New York: Wiley; 2002. p. 710.

    Book  Google Scholar 

  23. Woodward M. Epidemiology: study design and data analysis. 2nd ed. Boca Raton: Chapman & Hall/CRC; 2005. p. 849.

    Google Scholar 

  24. HRSA. The HIV/AIDS Program: HAB Performance Measures Group 1. http://hab.hrsa.gov/deliverhivaidscare/files/habgrp1pms08.pdf. Accessed 21 Dec 2011.

  25. Giordano TP, Visnegarwala F, White AC Jr, Troisi CL, Frankowski RF, Hartman CM, et al. Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure. AIDS Care. 2005;17(6):773–83.

    Article  PubMed  Google Scholar 

  26. Arici C, Ripamonti D, Maggiolo F, Rizzi M, Finazzi MG, Pezzotti P, et al. Factors associated with the failure of HIV-positive persons to return for scheduled medical visits. HIV Clin Trials. 2002;3(1):52–7.

    Article  PubMed  Google Scholar 

  27. Howe CJ, Cole SR, Napravnik S, Eron JJ. Enrollment, retention, and visit attendance in the University of North Carolina Center for AIDS Research HIV clinical cohort, 2001–2007. AIDS Res Hum Retroviruses. 2010;26(8):875–81.

    Article  PubMed  Google Scholar 

  28. Giordano TP, White AC Jr, Sajja P, Graviss EA, Arduino RC, Adu-Oppong A, et al. Factors associated with the use of highly active antiretroviral therapy in patients newly entering care in an urban clinic. J Acquir Immune Defic Syndr. 2003;32(4):399–405.

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to thank Jana Collins for providing insight and technical assistance on the collection of data used for the study.

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None.

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None.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Public Health, The University of Kentucky, 121 N. Martin Luther King #303, Lexington, KY, 40507, USA

    Timothy N. Crawford & Wayne T. Sanderson

  2. College of Medicine, The University of Kentucky, Lexington, KY, USA

    Alice Thornton

Authors
  1. Timothy N. Crawford
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  2. Wayne T. Sanderson
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  3. Alice Thornton
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Correspondence to Timothy N. Crawford.

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Crawford, T.N., Sanderson, W.T. & Thornton, A. A Comparison Study of Methods for Measuring Retention in HIV Medical Care. AIDS Behav 17, 3145–3151 (2013). https://doi.org/10.1007/s10461-013-0559-0

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  • DOI: https://doi.org/10.1007/s10461-013-0559-0

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