High Rates of Retention and Viral Suppression in the US HIV Safety Net System: HIV Care Continuum in the Ryan White HIV/AIDS Program, 2011

Doshi, Rupali; Milberg, John A.; Isenberg, Deborah; Matthews, Tracy; Malitz, Faye; Matosky, Marlene; Trent-Adams, Sylvia; Hopson, Deborah Parham; Cheever, Laura W.

doi:10.1093/cid/ciu722

Cited by 103 publications

(83 citation statements)

References 29 publications

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“…21,22 Even if 12-month retention had met the NHAS goal, we could not have claimed success as just over half (54%) of patients were continuously retained for the entire 24-month follow-up. Similarly, VS rates declined from 48% at 12 months to 38% at 24 continuous months.…”

Section: Discussionmentioning

confidence: 97%

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic

ColasantiJonathan

GoswamiNeela

KhoubianJonathan

et al. 2016

AIDS Research and Human Retroviruses

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The HIV care continuum has received considerable attention in recent years, however, few care continua focus on the population of patients who are diagnosed during an inpatient hospital admission. We aimed to describe the HIV care continuum for patients newly diagnosed during hospitalization through 24-month follow-up. A retrospective chart review of HIV patients diagnosed at Grady Memorial Hospital from 2011 to 2012 was performed and records were matched to Georgia Department of Public Health HIV/AIDS surveillance data. Descriptive statistics and statistical tests of independence were utilized. Ninety-four new diagnoses were confirmed during the 2-year study period. Median age was 43 years (interquartile range [IQR] 30-51), 77% were male, 72% were non-Hispanic Black, 31% were men who have sex with men (MSM), and 77% were uninsured. Median CD4 count at diagnosis was 134 cells/lL (IQR 30-307). Eighty-four percent received their diagnosis before hospital discharge, 68% linked to care by 90 days, 73% were retained for 12 months, 48% were virologically suppressed by 12 months, 58% were retained for 24 continuous months, and 38% achieved continuous viral suppression (VS) during the initial 24 months after diagnosis. Late diagnosis is a persistent problem in hospitalized patients. Despite relative success with linkage to care and 12-month retention in care, a minority of patients maintained retention and VS for 24 continuous months.

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Section: Discussionmentioning

confidence: 97%

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic

ColasantiJonathan

GoswamiNeela

KhoubianJonathan

et al. 2016

AIDS Research and Human Retroviruses

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“…In other jurisdictions where such initiatives are not widespread, additional challenges to the uptake and adherence to antiretroviral therapy may be encountered, which may compromise the ability to satisfy this legal test for HIV nondisclosure. Indeed, studies in other North American settings have found that members of marginalized and vulnerable groups, including people who inject drugs, 18-21 ethnic minorities, 22 sex workers 23 and homeless individuals, 24 experience barriers to accessing antiretroviral therapy and achieving sustained viral suppression.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of facing a legal obligation to disclose HIV serostatus to sexual partners among people living with HIV who inject drugs in a Canadian setting:a cross-sectional analysis

et al. 2016

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“…MMP specifically selects persons engaged in HIV medical care and excludes individuals with no medical visits during the sampling period [27]. However, evaluations of similarly engaged HIV-infected populations note comparable results, with retention rates between 82 and 89 % [30, 31]. Historically, patients with mental illness have been less likely to be prescribed ART [32–34].…”

Section: Discussionmentioning

confidence: 99%

Health Outcomes of HIV-Infected People with Mental Illness

et al. 2015

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Improving outcomes for people with HIV and mental illness will be critical to meeting the goals of the US National HIV/AIDS Strategy. In a retrospective analysis of the 2008–2010 cycles of the locally representative Philadelphia Medical Monitoring Project, we compared the proportions of HIV-infected adults with and without mental illness: (1) retained in care (≥2 primary HIV visits separated by ≥90 days in a 12-month period); (2) prescribed antiretroviral therapy (ART) at any point in a 12-month period; and (3) virally suppressed (HIV-1 RNA ≤200 copies/mL at the last measure in the 12-month period). Multivariable regression assessed associations between mental illness and the outcomes, adjusting for age, gender, race/ethnicity, insurance, alcohol abuse, injection drug use, CD4 count, and calendar year. Of 730 HIV-infected persons, representative of 9409 persons in care for HIV in Philadelphia, 49.0 % had mental illness. In adjusted analyses, there were no significant differences in retention (91.3 vs. 90.3 %; AOR 1.30, 95 % CI 0.63–2.56) and prescription of ART (83.2 vs. 88.7 %; AOR 0.79, 95 % CI 0.49–1.25) between those with and without mental illness. However, mentally ill patients were less likely to achieve viral suppression than those without mental illness (65.9 vs. 74.4 %; AOR 0.64, 95 % CI 0.46–0.90). These findings argue for the need to optimize ART adherence in this population.

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High Rates of Retention and Viral Suppression in the US HIV Safety Net System: HIV Care Continuum in the Ryan White HIV/AIDS Program, 2011

Cited by 103 publications

References 29 publications

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic

Prevalence and predictors of facing a legal obligation to disclose HIV serostatus to sexual partners among people living with HIV who inject drugs in a Canadian setting:a cross-sectional analysis

Health Outcomes of HIV-Infected People with Mental Illness

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