Loss to follow-up in a cohort of HIV-negative men who have sex with men: Project Horizonte

Abstract

OBJECTIVEThe objective of this study is to estimate the attrition rates and evaluate factors associated with loss to follow-up between 1994 and 2011 in an open cohort of HIV-negative men who have sex with men.METHODSThe Project Horizonte is an open cohort study that aimed to assess the incidence of HIV infection, evaluate the impact of educational interventions, and identify potential volunteers for HIV vaccine trials. The rates of losses to follow-up were estimated for three periods (1994–1999, 2000–2005, and 2006–2011). The variables analyzed were collected in a psychosocial questionnaire. Volunteers who dropped out were compared with the ones who remained in the study using a Cox regression model.RESULTSA total of 1,197 volunteers were recruited. The median follow-up time in the study (n = 626) was 4.2 years. The median follow-up time for the volunteers who dropped out of the study (n = 571) was 1.46 years. The overall rate of loss to follow-up was 11.6/100 person-years. Attrition rates by period were: 12.60 (1994–1999), 11.80 (2000–2005), and 9.00 (2006–2011) per 100 person-years. Factors associated with losses to follow-up were: age group of 21–30 years old, monthly per capita income of more than six or less than one Brazilian minimum wage, having more than two dependents, report of bisexual practice, and inconsistent use of condoms for receptive anal sex.CONCLUSIONSA slight decrease of the loss to follow-up was observed over time. Higher attrition rates happened in the first three years of follow-up. It is possible that the link of the volunteers were not yet well established. Those who reported inconsistent condom use in receptive anal sex were more likely to leave the study, suggesting an underestimation of the incidence of HIV infection in a cohort population. For greater effectiveness, retention strategies must be reassessed considering the connection between the characteristics of homosexual and bisexual behavior and the motivations to engage in health research.

Risk factors for loss to follow‐up among at‐risk HIV negative men who have sex with men participating in a research cohort with access to pre‐exposure prophylaxis in coastal Kenya

“…Men who had joined the cohort recently were more likely to be LTFU. Similarly, in a study conducted among HIV‐negative MSM in Brazil, the rate of LTFU was greatest in the first year of follow‐up [25]. While men without an altruistic reason to join a longitudinal study may soon lose interest in participating after their immediate needs (e.g.…”

Factors associated with loss to follow‐up after radiation therapy for head and neck cancer

“…As seen in the correlation matrix, race and marital status were positively associated ( p = 0.002) while income and distance from clinic were positively associated ( p < 0.001) (Table 3). Socioeconomic status and race have previously been shown to impact LTFU in other contexts 37,39,40 . Additional research is needed to better characterize how these factors contribute to receipt of follow‐up care since both have been shown to impact overall survival in patients with cancer 41,42 …”

Chemsex among men who have sex with men during the Mpox health crisis in Brazil: A nationwide web survey

“…The following practices were defined based on previous studies (Sousa et al., 2020; Sousa, Lima et al., 2023; Teixeira et al., 2022): Double Penetration (DP): simultaneous sexual penetration by two or more penises. Challenging Sexual Practice: Consistent involvement in two or three of these practices, defined based on the circumstances in which they occur. Fisting or Footing: Anal penetration using the fist or foot. Cruising: Free, consensual, and anonymous sex between men in public spaces like parks, forests, beaches, or parking lots. Gloryhole: A round opening in a wall allowing the insertion of the penis so that someone on the other side may engage with it sexually in various ways. Bugchasing: When an HIV‐negative man deliberately seeks out an HIV‐positive man to become infected (Silva et al., 2023). …”

“…Bugchasing: When an HIV‐negative man deliberately seeks out an HIV‐positive man to become infected (Silva et al., 2023).…”