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Factors Associated With Retention Among Non–Perinatally HIV-Infected Youth in the HIV Research Network

Identifieur interne : 001E26 ( Main/Merge ); précédent : 001E25; suivant : 001E27

Factors Associated With Retention Among Non–Perinatally HIV-Infected Youth in the HIV Research Network

Auteurs : Charles Farmer [États-Unis] ; Baligh R. Yehia [États-Unis] ; John A. Fleishman [États-Unis] ; Richard Rutstein ; W. Christopher Mathews ; Ank Nijhawan [États-Unis] ; Richard D. Moore [États-Unis] ; Kelly A. Gebo [États-Unis] ; Allison L. Agwu [États-Unis]

Source :

Journal of the Pediatric Infectious Diseases Society [ 2048-7193 ] ; 2014.

RBID : PMC:4765490

Abstract

Background

The transmission of human immunodeficiency virus (HIV) among youth through high-risk behaviors continues to increase. Retention in Care is associated with positive clinical outcomes and a decrease in HIV transmission risk behaviors. We evaluated the clinical and demographic characteristics of non–perinatally HIV (nPHIV)-infected youth associated with retention 1 year after initiating care and in the 2 years thereafter. We also assessed the impact retention in year 1 had on retention in years 2 and 3.

Methods

This was a retrospective analysis of treatment-naive nPHIV-infected 12- to 24-year-old youth presenting for care in 16 US HIV clinical sites within the HIV Research Network between 2002 and 2008. Multivariate logistic regression identified factors associated with retention.

Results

Of 1160 nPHIV-infected youth, 44.6% were retained in care during the first year, and 22.4% were retained in all 3 years. Retention in the first year was associated with starting antiretroviral therapy in the first year (adjusted odds ratio [AOR], 3.47 [95% confidence interval (CI), 2.57–4.67]), Hispanic ethnicity (AOR, 1.66 [95% CI, 1.08–2.56]), men who have sex with men (AOR, 1.59 [95% CI, 1.07–2.36]), and receiving care at a pediatric site (AOR, 5.37 [95% CI, 3.20–9.01]). Retention in years 2 and 3 was associated with being retained 1 year after initiating care (AOR, 7.44 [95% CI, 5.11–10.83]).

Conclusion

A high proportion of newly enrolled nPHIV-infected youth were not retained for 1 year, and only 1 in 4 were retained for 3 years. Patients who were Hispanic, were men who have sex with men, or were seen at pediatric clinics were more likely to be retained in care. Interventions that target those at risk of being lost to follow up are essential for this high-risk population.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765490

DOI: 10.1093/jpids/piu102
PubMed: 26908490
PubMed Central: 4765490

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PMC:4765490

Le document en format XML

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, Access, and Cost Trends,<institution>Agency for Healthcare Research and Quality</institution>
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<affiliation wicri:level="2"><nlm:aff id="af6"><addr-line>Department of Internal Medicine, UT Southwestern Medical Center</addr-line>
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, Baltimore, Maryland</nlm:aff>
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<affiliation wicri:level="2"><nlm:aff id="af8"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line>
,<institution>Johns Hopkins School of Medicine</institution>
, Baltimore, Maryland</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
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<wicri:cityArea>, Baltimore</wicri:cityArea>
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<author><name sortKey="Agwu, Allison L" sort="Agwu, Allison L" uniqKey="Agwu A" first="Allison L." last="Agwu">Allison L. Agwu</name>
<affiliation wicri:level="2"><nlm:aff id="af8"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line>
,<institution>Johns Hopkins School of Medicine</institution>
, Baltimore, Maryland</nlm:aff>
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<wicri:cityArea>, Baltimore</wicri:cityArea>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The transmission of human immunodeficiency virus (HIV) among youth through high-risk behaviors continues to increase. Retention in Care is associated with positive clinical outcomes and a decrease in HIV transmission risk behaviors. We evaluated the clinical and demographic characteristics of non–perinatally HIV (nPHIV)-infected youth associated with retention 1 year after initiating care and in the 2 years thereafter. We also assessed the impact retention in year 1 had on retention in years 2 and 3.</p>
</sec>
<sec><title>Methods</title>
<p>This was a retrospective analysis of treatment-naive nPHIV-infected 12- to 24-year-old youth presenting for care in 16 US HIV clinical sites within the HIV Research Network between 2002 and 2008. Multivariate logistic regression identified factors associated with retention.</p>
</sec>
<sec><title>Results</title>
<p>Of 1160 nPHIV-infected youth, 44.6% were retained in care during the first year, and 22.4% were retained in all 3 years. Retention in the first year was associated with starting antiretroviral therapy in the first year (adjusted odds ratio [AOR], 3.47 [95% confidence interval (CI), 2.57–4.67]), Hispanic ethnicity (AOR, 1.66 [95% CI, 1.08–2.56]), men who have sex with men (AOR, 1.59 [95% CI, 1.07–2.36]), and receiving care at a pediatric site (AOR, 5.37 [95% CI, 3.20–9.01]). Retention in years 2 and 3 was associated with being retained 1 year after initiating care (AOR, 7.44 [95% CI, 5.11–10.83]).</p>
</sec>
<sec><title>Conclusion</title>
<p>A high proportion of newly enrolled nPHIV-infected youth were not retained for 1 year, and only 1 in 4 were retained for 3 years. Patients who were Hispanic, were men who have sex with men, or were seen at pediatric clinics were more likely to be retained in care. Interventions that target those at risk of being lost to follow up are essential for this high-risk population.</p>
</sec>
</div>
</front>
</TEI>
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Factors Associated With Retention Among Non–Perinatally HIV-Infected Youth in the HIV Research Network

Factors Associated With Retention Among Non–Perinatally HIV-Infected Youth in the HIV Research Network

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Abstract

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