The Human Immunodeficiency Virus (HIV) Index: Using a Patient-Reported Outcome on Engagement in HIV Care to Explain Suboptimal Retention in Care and Virologic Control.

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Tytuł:: The Human Immunodeficiency Virus (HIV) Index: Using a Patient-Reported Outcome on Engagement in HIV Care to Explain Suboptimal Retention in Care and Virologic Control.
Autorzy:: Christopoulos KA; Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California, USA.
Neilands TB; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Koester KA; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Sauceda JA; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Dilworth SE; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Mugavero MJ; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Crane HM; Department of Medicine, University of Washington, Seattle, Washington, USA.
Fredericksen RJ; Department of Medicine, University of Washington, Seattle, Washington, USA.
Cachay ER; Department of Medicine, University of California, San Diego, San Diego, California, USA.
Mayer KH; The Fenway Institute at Fenway Health, Boston, Massachusetts, USA.
Moore RD; Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Napravnik S; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Johnson MO; Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Źródło:: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Oct 05; Vol. 73 (7), pp. e2175-e2183.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: Jan. 2011- : Oxford : Oxford University Press
Original Publication: Chicago, IL : The University of Chicago Press, c1992-
MeSH Terms:: Anti-HIV Agents*/therapeutic use
HIV Infections*/drug therapy
Retention in Care*
Cohort Studies ; HIV ; Humans ; Patient Reported Outcome Measures ; United States ; Viral Load
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Grant Information:: P30 MH062246 United States MH NIMH NIH HHS; R01 MH102198 United States GF NIH HHS; R24 AI067039 United States AI NIAID NIH HHS; P30 AI027763 United States AI NIAID NIH HHS; P30 AI060354 United States AI NIAID NIH HHS; P30 AI094189 United States AI NIAID NIH HHS; UL1 TR001872 United States TR NCATS NIH HHS
Contributed Indexing:: Keywords: HIV; engagement in care; patient-reported outcome; retention in care; viral suppression
Substance Nomenclature:: 0 (Anti-HIV Agents)
Entry Date(s):: Date Created: 20201229 Date Completed: 20211020 Latest Revision: 20220716
Update Code:: 20240105
PubMed Central ID:: PMC8492226
DOI:: 10.1093/cid/ciaa1892
PMID:: 33372942
: Czasopismo naukowe

Background: We investigated the prospective association between a brief self-report measure of engagement in human immunodeficiency virus (HIV) care (the Index of Engagement in HIV Care; hereafter "Index") and suboptimal retention and viral suppression outcomes.
Methods: The Centers for AIDS Research Network of Integrated Clinical Systems cohort study combines medical record data with patient-reported outcomes from 8 HIV clinics in the United States, which from April 2016 to March 2017 included the 10-item Index. Multivariable logistic regression was used to estimate the risk and odds ratios of mean Index scores on 2 outcomes in the subsequent year: (1) not keeping ≥75% of scheduled HIV care appointments; and (2) for those with viral suppression at Index assessment, having viral load >200 copies/mL on ≥1 measurement. We also used generalized linear mixed models (GLMMs) to estimate the risk and odds ratios of appointment nonattendance or unsuppressed viral load at any given observation. We generated receiver operating characteristic curves for the full models overlaid with the Index as a sole predictor.
Results: The mean Index score was 4.5 (standard deviation, 0.6). Higher Index scores were associated with lower relative risk of suboptimal retention (n = 2576; logistic regression adjusted risk ratio [aRR], 0.88 [95% confidence interval, .87-.88]; GLMM aRR, 0.85 [.83-.87]) and lack of sustained viral suppression (n = 2499; logistic regression aRR, 0.75 [.68-.83]; GLMM aRR, 0.74 [.68-.80]). The areas under the receiver operating characteristic curve for the full models were 0.69 (95% confidence interval, .67-.71) for suboptimal retention and 0.76 (.72-.79) for lack of sustained viral suppression.
Conclusions: Index scores are significantly associated with suboptimal retention and viral suppression outcomes.
(© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

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