Past Care Predicts Future Care in Out-of-Care People Living with HIV: Results of a Clinic-Based Retention-in-Care Intervention in North Carolina.
Poor retention in care is associated with higher viral load (VL) results and decreased rates of viral load suppression (VS) in people living with HIV (PLWH). Therefore, improving retention in HIV care is a priority of national significance. The NC-LINK Retention Project utilized a systematic approach to identify, locate, and attempt to return to care patients who did not attend a clinic appointment for 6-9 months. Clinical and surveillance data were used to evaluate associations between patient characteristics and VL outcomes. Between January 1, 2013 and December 31, 2014, 1118 patients at participating clinics were identified as out-of-care and referred to retention staff. Of these, 712 (64%) were located in North Carolina. Patients with recent prior medical care (aPR 1.43, 95% CI 1.25, 1.66) and recent VS (aPR 1.28, 95% CI 1.16, 1.41) were more likely to be located. Of located patients, 58% re-engaged in care within 90 days of retention referral. Patients who achieved VS within 180 days were more likely to be 40-49 years (aPR 1.19 95% CI 1.01-1.40; compared with 18-29 age group), had insurance at their last visit (aPR 1.19 95% CI 1.01-1.77), had a care visit in the prior year (aPR 1.37 95% CI 1.05-1.77), and had VS at the prior care visit (aPR 2.54 95% CI 1.98-3.25). Clinic-based retention efforts may be effective at helping PLWH decrease out-of-care periods, but prior patterns of care usage persist.
['Donovan|Jenna|J|', 'Sullivan|Kristen|K|', 'Wilkin|Aimee|A|', 'Fadul|Nada|N|', 'Heine|Amy|A|', 'Keller|Jennifer|J|', 'LeViere|Anna|A|', 'Quinlivan|Evelyn Byrd|EB|http://orcid.org/0000-0002-1213-8707']
D000293:Adolescent D000328:Adult D000554:Ambulatory Care Facilities D001071:Appointments and Schedules D019090:Case Management D005260:Female D015658:HIV Infections D006801:Humans D008297:Male D008875:Middle Aged D009657:North Carolina D062526:Patient Navigation D010358:Patient Participation D012017:Referral and Consultation D000076522:Retention in Care D013689:Telephone D019562:Viral Load D055815:Young Adult
Out-of-care Retention in care HIV care