Despite numerous studies of the relationships among symptoms manifested by children and adolescents, there have been few systematic attempts to group individuals on the basis of the syndromes identified. In the course of a treatment evaluation project requiring classification of both child patients and untreated controls, the present study was conducted to determine whether replicable types of children and adolescents could be identified by the cluster analysis of their IJR Behavior Checklist profiles. One clinical sample (N = 185) and two mixed clinical and normal subsamples (Ns of 358 and 373) were cluster-analyzed separately. Seven types that replicated across at least two subsamples were identified: (1) High Assets, Flat Symptom Profile; (2) Sociopathic, Academic Problems; (3) Moderate Assets, Egocentric, Incontinent; (4) Insecure, Somaticizing, Underachieving; (5) Aggressive, Overreactive; (6) Schizoid, Withdrawn, Anxious, Bizarre; and (7) Diffuse, Mixed Pathology. The issue posed by the title of the article was explored in the light of the findings.
The Caribbean has the highest adult HIV prevalence in the world after sub-Saharan Africa (2011). One sub-population in the Dominican Republic is the migratory Batey community primarily comprised of Haitian immigrants with limited access to healthcare and HIV prevalence rates of between 3.0% and 9.0%, compared to 0.7% nationally. This retrospective cohort study describes the cumulative retention from diagnosis to virological suppression for newly-diagnosed HIV-infected adults presenting to the Clínica de Familia and its Batey programme in La Romana, during 2011. Of the patients diagnosed with HIV, 65% entered into care, 59% completed immunologic testing, 53% were eligible for antiretroviral therapy (ART) initiation, 36% initiated ART within three months of eligibility and 27% were retained in care. Seventeen per cent of those retained on ART with a 12-month viral load measure had undetectable viral load. Attrition primarily occurred before ART initiation. The Batey programme had a first step lost-to-follow-up of 88% compared to 20% at the clinic (p < 0.001). This retrospective study details the continuum of care and indicates where structural changes must occur to increase continuity between steps. The manuscript results are important to help implement programmes to enhance engagement and retention in HIV primary care.
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