Implementation of Mental Health Service Has an Impact on Retention in HIV Care: A Nested Case-Control Study in a Japanese HIV Care Facility

Abstract

BackgroundPoor retention in the care of patients with human immunodeficiency virus (HIV) is associated with adverse patient outcomes such as antiretroviral therapy failure and death. Therefore, appropriate case management is required for better patient retention; however, which intervention in case management is important has not been fully investigated. Meanwhile, in Japan, each local government is required to organize mental health services for patients with HIV so that a case manager at an HIV care facility can utilize them, but little is known about the association between implementation of the services and loss to follow-up. Therefore, we investigated that by a nested case-control study.MethodsThe target population consisted of all patients with HIV who visited Osaka National Hospital, the largest HIV care facility in western Japan, between 2000 and 2010. Loss to follow-up was defined as not returning for follow-up care more than 1 year after the last visit. Independent variables included patient demographics, characteristics of the disease and treatment, and whether the patients have received mental health services. For each case, three controls were randomly selected and matched.ResultsOf the 1620 eligible patients, 88 loss to follow-up cases were identified and 264 controls were matched. Multivariate-adjusted conditional logistic regression revealed that loss to follow-up was less frequent among patients who had received mental health services implemented by their case managers (adjusted odds ratio [95% confidence interval] 0.35 [0.16-0.76]). Loss to follow-up also occurred more frequently in patients who did not receive antiretroviral therapy (adjusted odds ratio [95% confidence interval], 7.51 [3.34-16.9]), who were under 30 years old (2.74 [1.36-5.50]), or who were without jobs (3.38 [1.58-7.23]).ConclusionMental health service implementation by case managers has a significant impact on patient retention.

Evaluating patterns in retention, continuation, gaps, and re-engagement in HIV care in a Medicaid-insured population, 2006–2012, United States

“…Although it is unknown whether persons diagnosed with mental illness were receiving treatment or other mental health services, psychiatric treatment might be partially responsible for this negative association; receipt of psychiatric medications and ancillary mental health services have been shown to improve retention in care among HIV-infected persons (Cunningham et al, 2007; Lo, MacGovern, & Bradford, 2002; Sherer et al, 2002; Tominari et al, 2013). …”

Mental health among men who have sex with men in Cambodia: Implications for integration of mental health services within HIV programmes

“…Yet mental health is an important determinant of HIV outcomes: among people living with HIV (PLHIV), untreated or poor mental health contributes to late recruitment onto antiretroviral therapy (ART) [ 10 , 11 ], poor adherence to ART [ 12 – 14 ] and low retention in care [ 15 , 16 ]. Among PLHIV, mental disorders have also been associated with higher rates of HIV disease progression [ 17 , 18 ], hospitalizations [ 19 , 20 ], viralogical failure [ 18 ], and mortality, including suicides [ 21 ].…”

Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV: A Scoping Review

“…All the studies in this review reported increased retention and adherence to ART among adolescents and young people following the administration of an intervention with psychosocial components [38,39,41,42,45]. Evidence from other studies show that psychosocial interventions comprising of counselling and educational components were effective in increasing adherence to ART among adult patients [57][58][59]. A study evaluating the effects of a psychosocial intervention among PLHIV attending clinical care in Estonia reported that the intervention increased the proportion of patients that were optimally adherent [57].…”

“…A study evaluating the effects of a psychosocial intervention among PLHIV attending clinical care in Estonia reported that the intervention increased the proportion of patients that were optimally adherent [57]. Similarly, a study conducted by Tominari et al, [59] reported that the implementation of mental health services demonstrated a signi cant increase in retention in care among PLHIV.…”