Home > Factors associated with non-retention in HIV care in an era of widespread antiretroviral therapy.

O'Connell, Sarah and O'Rourke, Anna and Sweeney, Eileen and Lynam, Almida and Sadlier, Corinna and Bergin, Colm (2017) Factors associated with non-retention in HIV care in an era of widespread antiretroviral therapy. International Journal of STD & AIDS, 28, (7), pp. 679-684.

In an era of antiretroviral therapy (ART) for all HIV-1-infected patients, our primary aim was to describe prevalence and characteristics of patients disengaged from care at an urban ambulatory HIV clinic. We conducted a nested case-control study. All patients who disengaged from care (defined as being lost to follow-up for at least one year) from 2007 to 2014 inclusive were identified. Cases were matched to controls in a 1:4 ratio. A total of 1250 cases were included; 250/2289 (10.9%) of patients attending our HIV clinic disengaged from 2007 to 2014. One hundred and twenty-six (50.4%) were heterosexual, 81 (32.4%) were men who have sex with men and 40 (16%) were intravenous drug users.

On univariate analysis only, patients with heterosexual risk were more likely to disengage from care (50.4% vs. 33.7%, p: <0.001). Those who disengaged were younger, mean age of 39 (p: <0.001). A higher proportion of patients who disengaged from care was not receiving ART and did not have a suppressed HIV-1 viral load (p: <0.001). On multivariable analysis, Irish patients were less likely to disengage from HIV care (odds ratio: 0.567, p: 0.002). Factors associated with non-retention in HIV care have been identified. A semi-structured interview of those patients who re-engaged will take place to further examine reasons for disengagement from care.


Item Type
Article
Publication Type
Irish-related, International, Article
Drug Type
Substances (not alcohol/tobacco), Opioid
Intervention Type
Harm reduction
Date
2017
Page Range
pp. 679-684
Publisher
Sage
Volume
28
Number
7
EndNote
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