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High retention in HIV care at a tertiary care centre in Toronto, Canada.

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Title: High retention in HIV care at a tertiary care centre in Toronto, Canada.
Authors: Szadkowski, Leah, Walmsley, Sharon, Burchell, Ann N., Collins, Evan, Rourke, Sean B., Raboud, Janet
Source: AIDS Care. Feb2018, Vol. 30 Issue 2, p246-254. 9p. 1 Diagram, 5 Charts.
Subjects: Age distribution, Mental depression, Drugs of abuse, Psychology of HIV-positive persons, Multivariate analysis, Patient compliance, Questionnaires, Race, Sample size (Statistics), Viral load, Intravenous drug abusers, Patient dropouts, Disease duration, Data analysis software, Descriptive statistics, CD4 lymphocyte count, Tertiary care
Geographic Terms: Canada
Abstract: Poor retention in HIV care is associated with poor clinical outcomes and mortality. Previous studies of predictors of poor retention have been conducted with a wide variety of populations, using different measures of retention, and occasionally have conflicting results. We studied demographic and psychosocial factors associated with inter-visit interval length in a setting of universal health care and modern cART. Patients attending ≥2 appointments with an HIV specialist at the Toronto General Hospital Immunodeficiency Clinic from 2004 to 2013 were studied. A sub-analysis included psychosocial measures from annual questionnaires for Ontario HIV Treatment Network Cohort Study (OCS) participants. Median inter-visit interval and constancy (percentage of 4-month intervals with ≥1 visit) were calculated by patient. Multivariable generalized estimating equation models identified factors associated with inter-visit interval length and intervals ≥12 months. 1591 patients were included. 615 patients completed an OCS questionnaire and were more likely to be older white MSM from Canada with a viral load (VL) <50 copies/ml. The median (IQR) of patients’ median inter-visit intervals was 3.15 (2.78, 3.84) months and median (IQR) constancy was 90% (71%, 100%). Two percent of inter-visit intervals were ≥12 months and 25% of patients had ≥1 interval ≥12 months. Longer inter-visit intervals were associated with younger age, white race, earlier calendar year, longer duration of HIV, VL < 50 copies/mL and higher CD4 counts. Patients who were younger, white, had injection drug use as a risk factor, had a longer duration of HIV, and had VL ≥50 copies/mL were more likely to have an inter-visit interval ≥12 months. In the OCS sub-analysis including psychosocial variables, lower levels of depression were associated with longer inter-visit intervals. Retention at this tertiary care centre was high. Efforts to maximize attendance should focus on younger patients and those with substance abuse issues. [ABSTRACT FROM PUBLISHER]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Feb2018, Vol. 30 Issue 2, p246-254. 9p. 1 Diagram, 5 Charts.
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  Data: Poor retention in HIV care is associated with poor clinical outcomes and mortality. Previous studies of predictors of poor retention have been conducted with a wide variety of populations, using different measures of retention, and occasionally have conflicting results. We studied demographic and psychosocial factors associated with inter-visit interval length in a setting of universal health care and modern cART. Patients attending ≥2 appointments with an HIV specialist at the Toronto General Hospital Immunodeficiency Clinic from 2004 to 2013 were studied. A sub-analysis included psychosocial measures from annual questionnaires for Ontario HIV Treatment Network Cohort Study (OCS) participants. Median inter-visit interval and constancy (percentage of 4-month intervals with ≥1 visit) were calculated by patient. Multivariable generalized estimating equation models identified factors associated with inter-visit interval length and intervals ≥12 months. 1591 patients were included. 615 patients completed an OCS questionnaire and were more likely to be older white MSM from Canada with a viral load (VL) &lt;50 copies/ml. The median (IQR) of patients’ median inter-visit intervals was 3.15 (2.78, 3.84) months and median (IQR) constancy was 90% (71%, 100%). Two percent of inter-visit intervals were ≥12 months and 25% of patients had ≥1 interval ≥12 months. Longer inter-visit intervals were associated with younger age, white race, earlier calendar year, longer duration of HIV, VL &lt; 50 copies/mL and higher CD4 counts. Patients who were younger, white, had injection drug use as a risk factor, had a longer duration of HIV, and had VL ≥50 copies/mL were more likely to have an inter-visit interval ≥12 months. In the OCS sub-analysis including psychosocial variables, lower levels of depression were associated with longer inter-visit intervals. Retention at this tertiary care centre was high. Efforts to maximize attendance should focus on younger patients and those with substance abuse issues. [ABSTRACT FROM PUBLISHER]
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  Data: &lt;i&gt;Copyright of AIDS Care is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=126669584
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2017.1349278
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 246
    Subjects:
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Drugs of abuse
        Type: general
      – SubjectFull: Psychology of HIV-positive persons
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Race
        Type: general
      – SubjectFull: Sample size (Statistics)
        Type: general
      – SubjectFull: Viral load
        Type: general
      – SubjectFull: Intravenous drug abusers
        Type: general
      – SubjectFull: Patient dropouts
        Type: general
      – SubjectFull: Disease duration
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: CD4 lymphocyte count
        Type: general
      – SubjectFull: Tertiary care
        Type: general
      – SubjectFull: Canada
        Type: general
    Titles:
      – TitleFull: High retention in HIV care at a tertiary care centre in Toronto, Canada.
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            NameFull: Szadkowski, Leah
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            NameFull: Walmsley, Sharon
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            NameFull: Burchell, Ann N.
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            NameFull: Collins, Evan
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            NameFull: Rourke, Sean B.
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            – D: 01
              M: 02
              Text: Feb2018
              Type: published
              Y: 2018
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              Value: 09540121
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              Value: 30
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            – TitleFull: AIDS Care
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