201818 Retention in care among adults infected with HIV

Wednesday, November 11, 2009: 12:50 PM

Katherine A. Marx, MS, MPH , SUNY Downstate Medical Center, Brooklyn, NY
Rebecca M. Schwartz, PhD , Graduate Program in Public Health, SUNY Downstate Medical Center, Brooklyn, NY
Edmond S. Malka, MPH, CPH , Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, New Brunswick, NJ
Jayashree Ravishankar, MD, MPH , SUNY Downstate Medical Center, Brooklyn, NY
Background: Adults infected with HIV live longer when they receive regular medical care, yet many adults are not retained in care. This study compares two methods of operationalizing retention and evaluates the contribution of individual characteristics on likelihood of retention.

Methods: A chart review was performed for a random sample of 212 active clients of an HIV primary care clinic. Data on clinic utilization, sex, age, race, mental illness, substance use, AIDS diagnosis, language, and housing were collected for each participant. Clinic utilization data was used to classify participants for retention and to score them by frequency of visits.

Results: Binary logistic regression analysis was compared to ordinal logistic regression analysis, using distinct retention measures as outcome variables. In the binary model, those with a history of substance use were about half as likely to be retained (p=.030) and those with an AIDS diagnosis were more than 2 times as likely to be retained (p=.015). These characteristics were also significant predictors in the ordinal model, with the additional finding that those reporting primary language other than English were more likely to have higher retention scores (p=.015).

Conclusions: Individual characteristics are associated with retention in care. An ordinal score for retention can identify unexpected predictors, but a dichotomous measure of retention may be easier to use and interpret for providers involved in retention-related quality improvement activities.

Learning Objectives:
1. Compare definitions of retention in care currently in use for research and quality improvement activities 2. Evaluate the contribution of individual characteristics to likelihood of retention in care

Keywords: HIV/AIDS, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the person responsible for data collection, data analysis and writing for the project described in the abstract; this work was completed for coursework in my graduate program in public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.