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Non‐ HIV ‐related health care utilization, demographic, clinical and laboratory factors associated with time to initial retention in HIV care among HIV ‐positive individuals linked to HIV care
Author(s) -
Lourenço L,
Nohpal A,
Shopin D,
Colley G,
Nosyk B,
Montaner JSG,
Lima VD
Publication year - 2016
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12297
Subject(s) - medicine , human immunodeficiency virus (hiv) , family medicine
Objectives The aim of the study was to explore non‐ HIV ‐related health care service ( NHRHS ) utilization, demographic, clinical and laboratory factors associated with timely initial “retention” in HIV care among individuals “linked” to HIV care in B ritish C olumbia ( BC ), C anada. Methods We conducted a W eibull time‐to‐initial‐retention analysis among BC Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort participants linked in 2000–2010, who had ≥ 1 year of follow‐up. We defined “linked” as the first HIV ‐related service accessed following HIV diagnosis and “retained” as having, within a calendar year, either: (i) at least two HIV ‐related physician visits/diagnostic tests or (ii) at least two antiretroviral therapy ( ART ) dispensations, ≥ 3 months apart. Individuals were followed until they were retained, died, their last contact date, or until 31 D ecember 2011, whichever occurred first. Results Of 5231 linked individuals (78% male; median age 39: ( Q1 − Q3 : 32–46) years], 4691 (90%) were retained [median time to initial retention of 9 (Q1–Q3: 5–13) months] by the end of follow‐up and 540 (10%) were not. Eighty‐four per cent of not retained and 96% of retained individuals used at least one type of NHRHS during follow‐up. Individuals who saw a specialist for NHRHS during follow‐up had a shorter time to initial retention than those who did not [adjusted hazard ratio ( aHR ) 2.79; 95% confidence interval ( CI ): 2.47–3.16]. However, those who saw a general practitioner ( GP ) for NHRHS ( aHR 0.79; 95% CI : 0.74–0.84) and those admitted to the hospital for NHRHS ( aHR 0.60; 95% CI : 0.54–0.67), versus those who did/were not, respectively, had longer times to initial retention, as did female patients, people who inject drugs ( PWID ) and individuals < 40 years old. Conclusions Overall, 84% of not retained individuals used some type of NHRHS during follow‐up. Given that 71% of not retained individuals used GP NHRHS , our results suggest that GP ‐targeted interventions may be effective in improving time to initial retention.