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Gaps in the continuum of care in HIV-positive adults and the need for caution in those returning to care after loss to follow-up.

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Title: Gaps in the continuum of care in HIV-positive adults and the need for caution in those returning to care after loss to follow-up.
Authors: Martinez-Guerra, Bernardo A., Valdez-Ventura, Rafael, Caro-Vega, Yanink, Sierra-Madero, Juan G., Crabtree-Ramírez, Brenda E.
Source: AIDS Care. Oct2023, Vol. 35 Issue 10, p1604-1611. 8p. 1 Diagram, 3 Charts, 2 Graphs.
Subjects: HIV infection transmission, HIV infections, Patient aftercare, Scientific observation, Time, Multivariate analysis, Age distribution, Research methodology, Antiretroviral agents, Retrospective studies, Continuum of care, Comparative studies, Descriptive statistics, CD4 lymphocyte count, Patient compliance, Men who have sex with men, Psychology of HIV-positive persons, Longitudinal method, HIV, Adults
Abstract: Loss to follow-up (LTFU) and interruption of antiretroviral therapy (ART) are associated with worse outcomes in people with HIV (PWH). Little is known about gaps in the continuum of care. We conducted a retrospective cohort study including adult PWH with at least one clinical visit during 2000-2017. Three groups of care were defined: those constantly retained in care (constantly-RIC), definitively LTFU (dLTFU), and those who returned to care (RTC) after being LTFU for 1 year. We analyzed characteristics of individuals at enrollment. Among 2967 patients, 1565 (53%) were constantly-RIC, 826 (28%) dLTFU, and 576 (19%) RTC. CD4+ ≥350 cells/μL at enrollment was more frequent in RTC patients (43% vs 28% in both constantly-RIC and dLTFU groups, p < 0.01). Time since enrollment to ART initiation was longer in dLTFU (3.3 weeks) and RTC groups (6.0 weeks) in comparison with constantly-RIC patients (2.0 weeks, p < 0.01). Multivariate analysis showed significant differences between groups. Older and ART-naïve patients at enrollment were less likely to have gaps in the continuum of care. Those with non-MSM transmission were less likely to RTC. Patients with CD4+ ≥350 cells/μL at enrollment were more likely to reengage in care. Interventions should be tailored for those at risk of LTFU [ABSTRACT FROM AUTHOR]
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.)
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  Data: Gaps in the continuum of care in HIV-positive adults and the need for caution in those returning to care after loss to follow-up.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Oct2023, Vol. 35 Issue 10, p1604-1611. 8p. 1 Diagram, 3 Charts, 2 Graphs.
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  Label: Abstract
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  Data: Loss to follow-up (LTFU) and interruption of antiretroviral therapy (ART) are associated with worse outcomes in people with HIV (PWH). Little is known about gaps in the continuum of care. We conducted a retrospective cohort study including adult PWH with at least one clinical visit during 2000-2017. Three groups of care were defined: those constantly retained in care (constantly-RIC), definitively LTFU (dLTFU), and those who returned to care (RTC) after being LTFU for 1 year. We analyzed characteristics of individuals at enrollment. Among 2967 patients, 1565 (53%) were constantly-RIC, 826 (28%) dLTFU, and 576 (19%) RTC. CD4+ ≥350 cells/μL at enrollment was more frequent in RTC patients (43% vs 28% in both constantly-RIC and dLTFU groups, p &lt; 0.01). Time since enrollment to ART initiation was longer in dLTFU (3.3 weeks) and RTC groups (6.0 weeks) in comparison with constantly-RIC patients (2.0 weeks, p &lt; 0.01). Multivariate analysis showed significant differences between groups. Older and ART-na&#239;ve patients at enrollment were less likely to have gaps in the continuum of care. Those with non-MSM transmission were less likely to RTC. Patients with CD4+ ≥350 cells/μL at enrollment were more likely to reengage in care. Interventions should be tailored for those at risk of LTFU [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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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.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2022.2150139
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 1604
    Subjects:
      – SubjectFull: HIV infection transmission
        Type: general
      – SubjectFull: HIV infections
        Type: general
      – SubjectFull: Patient aftercare
        Type: general
      – SubjectFull: Scientific observation
        Type: general
      – SubjectFull: Time
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Antiretroviral agents
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Continuum of care
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: CD4 lymphocyte count
        Type: general
      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Men who have sex with men
        Type: general
      – SubjectFull: Psychology of HIV-positive persons
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: HIV
        Type: general
      – SubjectFull: Adults
        Type: general
    Titles:
      – TitleFull: Gaps in the continuum of care in HIV-positive adults and the need for caution in those returning to care after loss to follow-up.
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            NameFull: Martinez-Guerra, Bernardo A.
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            NameFull: Valdez-Ventura, Rafael
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            NameFull: Caro-Vega, Yanink
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            NameFull: Sierra-Madero, Juan G.
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            NameFull: Crabtree-Ramírez, Brenda E.
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          Dates:
            – D: 01
              M: 10
              Text: Oct2023
              Type: published
              Y: 2023
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              Value: 35
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              Value: 10
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