HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care

Consistent engagement in care is associated with positive health outcomes among people living with HIV (PLWH). However, traditional retention measures ignore the evolving dynamics of engagement in care. To understand the longitudinal patterns of HIV care, we analyzed medical records from 2008 to 201...

Full description

Saved in:
Bibliographic Details
Published in:AIDS and behavior 2019-09, Vol.23 (9), p.2532-2541
Main Authors: Enns, Eva A., Reilly, Cavan S., Horvath, Keith J., Baker-James, Karen, Henry, Keith
Format: Article
Language:English
Subjects:
Adolescent
Ambulatory Care Facilities
Antiretroviral drugs
Attrition
Continuity of Patient Care
Health problems
Health Psychology
Health services
HIV
HIV Infections - drug therapy
HIV Infections - virology
Human immunodeficiency virus
Humans
Infectious Diseases
Latent Class Analysis
Longitudinal Studies
Male
Medical records
Medicine
Medicine & Public Health
Minnesota
Original Paper
Public Health
Retention
Retention in Care
Trajectories
Treatment Outcome
Viral Load
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003
cites cdi_FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003
container_end_page 2541
container_issue 9
container_start_page 2532
container_title AIDS and behavior
container_volume 23
creator Enns, Eva A.
Reilly, Cavan S.
Horvath, Keith J.
Baker-James, Karen
Henry, Keith
description Consistent engagement in care is associated with positive health outcomes among people living with HIV (PLWH). However, traditional retention measures ignore the evolving dynamics of engagement in care. To understand the longitudinal patterns of HIV care, we analyzed medical records from 2008 to 2015 of PLWH ≥ 18 years-old receiving care at a public, hospital-based HIV clinic (N = 2110). Using latent class analysis, we identified five distinct care trajectory classes: (1) consistent care (N = 1281); (2) less frequent care (N = 270); (3) return to care after initial attrition (N = 192); (4) moderate attrition (N = 163); and (5) rapid attrition (N = 204). The majority of PLWH in Class 1 (73.9%) had achieved sustained viral suppression (viral load ≤ 200 copies/mL at last test and > 12 months prior) by study end. Among the other care classes, there was substantial variation in sustained viral suppression (61.1% in Class 2 to 3.4% in Class 5). Care trajectories could be used to prioritize re-engagement efforts.
doi_str_mv 10.1007/s10461-019-02450-7
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8944932</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2190109717</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003</originalsourceid><addsrcrecordid>eNp9kU1PGzEQhi0EIhD4Az0gS730su34a72-IKGIQqQUJBS4Wo7XmzrarMHeReq_r0PSlPaAZGlGnsevZ-ZF6BOBrwRAfksEeEkKIKoAygUU8gCdECFZwajghzkHlS9JKUboNKUVAKhSqmM0YlAJKqk6QT9up094YqLD82hWzvYhepewyQffhVfX4lnolr4fat-ZFl-l5FJau67HocEPrs-ZDx323ZvIGTpqTJvc-S6O0eP36_nktpjd30wnV7PCcsn7QhAJRlhjmppVJTMLVoGQyla1qIgoVVPXFkooqXANKNEYAbY2pbEKFtYCsDG63Oo-D4u1q23uIppWP0e_NvGXDsbrfyud_6mX4VVXinPFaBb4shOI4WVwqddrn6xrW9O5MCRNiYK8PUlkRj__h67CEPMyNlSlKOcgVabolrIxpBRds2-GgN64pbdu6eyWfnNLb6Qv3o-xf_LHngywLZByqVu6-PfvD2R_A7f9n60</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2189244079</pqid></control><display><type>article</type><title>HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care</title><source>Criminology Collection</source><source>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</source><source>Sociology Collection</source><source>Springer Link</source><source>Sociological Abstracts</source><creator>Enns, Eva A. ; Reilly, Cavan S. ; Horvath, Keith J. ; Baker-James, Karen ; Henry, Keith</creator><creatorcontrib>Enns, Eva A. ; Reilly, Cavan S. ; Horvath, Keith J. ; Baker-James, Karen ; Henry, Keith</creatorcontrib><description>Consistent engagement in care is associated with positive health outcomes among people living with HIV (PLWH). However, traditional retention measures ignore the evolving dynamics of engagement in care. To understand the longitudinal patterns of HIV care, we analyzed medical records from 2008 to 2015 of PLWH ≥ 18 years-old receiving care at a public, hospital-based HIV clinic (N = 2110). Using latent class analysis, we identified five distinct care trajectory classes: (1) consistent care (N = 1281); (2) less frequent care (N = 270); (3) return to care after initial attrition (N = 192); (4) moderate attrition (N = 163); and (5) rapid attrition (N = 204). The majority of PLWH in Class 1 (73.9%) had achieved sustained viral suppression (viral load ≤ 200 copies/mL at last test and &gt; 12 months prior) by study end. Among the other care classes, there was substantial variation in sustained viral suppression (61.1% in Class 2 to 3.4% in Class 5). Care trajectories could be used to prioritize re-engagement efforts.</description><identifier>ISSN: 1090-7165</identifier><identifier>EISSN: 1573-3254</identifier><identifier>DOI: 10.1007/s10461-019-02450-7</identifier><identifier>PMID: 30852729</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Ambulatory Care Facilities ; Antiretroviral drugs ; Attrition ; Continuity of Patient Care ; Health problems ; Health Psychology ; Health services ; HIV ; HIV Infections - drug therapy ; HIV Infections - virology ; Human immunodeficiency virus ; Humans ; Infectious Diseases ; Latent Class Analysis ; Longitudinal Studies ; Male ; Medical records ; Medicine ; Medicine &amp; Public Health ; Minnesota ; Original Paper ; Public Health ; Retention ; Retention in Care ; Trajectories ; Treatment Outcome ; Viral Load</subject><ispartof>AIDS and behavior, 2019-09, Vol.23 (9), p.2532-2541</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>AIDS and Behavior is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003</citedby><cites>FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003</cites><orcidid>0000-0003-0693-7358</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2189244079/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2189244079?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,21376,21394,21395,27344,27924,27925,33611,33612,33769,33770,33774,34530,34531,43733,43814,44115,74221,74310,74639</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30852729$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Enns, Eva A.</creatorcontrib><creatorcontrib>Reilly, Cavan S.</creatorcontrib><creatorcontrib>Horvath, Keith J.</creatorcontrib><creatorcontrib>Baker-James, Karen</creatorcontrib><creatorcontrib>Henry, Keith</creatorcontrib><title>HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care</title><title>AIDS and behavior</title><addtitle>AIDS Behav</addtitle><addtitle>AIDS Behav</addtitle><description>Consistent engagement in care is associated with positive health outcomes among people living with HIV (PLWH). However, traditional retention measures ignore the evolving dynamics of engagement in care. To understand the longitudinal patterns of HIV care, we analyzed medical records from 2008 to 2015 of PLWH ≥ 18 years-old receiving care at a public, hospital-based HIV clinic (N = 2110). Using latent class analysis, we identified five distinct care trajectory classes: (1) consistent care (N = 1281); (2) less frequent care (N = 270); (3) return to care after initial attrition (N = 192); (4) moderate attrition (N = 163); and (5) rapid attrition (N = 204). The majority of PLWH in Class 1 (73.9%) had achieved sustained viral suppression (viral load ≤ 200 copies/mL at last test and &gt; 12 months prior) by study end. Among the other care classes, there was substantial variation in sustained viral suppression (61.1% in Class 2 to 3.4% in Class 5). Care trajectories could be used to prioritize re-engagement efforts.</description><subject>Adolescent</subject><subject>Ambulatory Care Facilities</subject><subject>Antiretroviral drugs</subject><subject>Attrition</subject><subject>Continuity of Patient Care</subject><subject>Health problems</subject><subject>Health Psychology</subject><subject>Health services</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - virology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Latent Class Analysis</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Minnesota</subject><subject>Original Paper</subject><subject>Public Health</subject><subject>Retention</subject><subject>Retention in Care</subject><subject>Trajectories</subject><subject>Treatment Outcome</subject><subject>Viral Load</subject><issn>1090-7165</issn><issn>1573-3254</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>BGRYB</sourceid><sourceid>BHHNA</sourceid><sourceid>HEHIP</sourceid><sourceid>M0O</sourceid><sourceid>M2S</sourceid><recordid>eNp9kU1PGzEQhi0EIhD4Az0gS730su34a72-IKGIQqQUJBS4Wo7XmzrarMHeReq_r0PSlPaAZGlGnsevZ-ZF6BOBrwRAfksEeEkKIKoAygUU8gCdECFZwajghzkHlS9JKUboNKUVAKhSqmM0YlAJKqk6QT9up094YqLD82hWzvYhepewyQffhVfX4lnolr4fat-ZFl-l5FJau67HocEPrs-ZDx323ZvIGTpqTJvc-S6O0eP36_nktpjd30wnV7PCcsn7QhAJRlhjmppVJTMLVoGQyla1qIgoVVPXFkooqXANKNEYAbY2pbEKFtYCsDG63Oo-D4u1q23uIppWP0e_NvGXDsbrfyud_6mX4VVXinPFaBb4shOI4WVwqddrn6xrW9O5MCRNiYK8PUlkRj__h67CEPMyNlSlKOcgVabolrIxpBRds2-GgN64pbdu6eyWfnNLb6Qv3o-xf_LHngywLZByqVu6-PfvD2R_A7f9n60</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Enns, Eva A.</creator><creator>Reilly, Cavan S.</creator><creator>Horvath, Keith J.</creator><creator>Baker-James, Karen</creator><creator>Henry, Keith</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7T2</scope><scope>7U3</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AM</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGRYB</scope><scope>BHHNA</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HEHIP</scope><scope>K7.</scope><scope>K9.</scope><scope>KB0</scope><scope>M0O</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0693-7358</orcidid></search><sort><creationdate>20190901</creationdate><title>HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care</title><author>Enns, Eva A. ; Reilly, Cavan S. ; Horvath, Keith J. ; Baker-James, Karen ; Henry, Keith</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Ambulatory Care Facilities</topic><topic>Antiretroviral drugs</topic><topic>Attrition</topic><topic>Continuity of Patient Care</topic><topic>Health problems</topic><topic>Health Psychology</topic><topic>Health services</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - virology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infectious Diseases</topic><topic>Latent Class Analysis</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Minnesota</topic><topic>Original Paper</topic><topic>Public Health</topic><topic>Retention</topic><topic>Retention in Care</topic><topic>Trajectories</topic><topic>Treatment Outcome</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Enns, Eva A.</creatorcontrib><creatorcontrib>Reilly, Cavan S.</creatorcontrib><creatorcontrib>Horvath, Keith J.</creatorcontrib><creatorcontrib>Baker-James, Karen</creatorcontrib><creatorcontrib>Henry, Keith</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing &amp; Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Social Services Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Criminal Justice Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Criminology Collection</collection><collection>Sociological Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Sociology Collection</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Criminal Justice Periodicals</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology Journals</collection><collection>ProQuest Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>AIDS and behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Enns, Eva A.</au><au>Reilly, Cavan S.</au><au>Horvath, Keith J.</au><au>Baker-James, Karen</au><au>Henry, Keith</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care</atitle><jtitle>AIDS and behavior</jtitle><stitle>AIDS Behav</stitle><addtitle>AIDS Behav</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>23</volume><issue>9</issue><spage>2532</spage><epage>2541</epage><pages>2532-2541</pages><issn>1090-7165</issn><eissn>1573-3254</eissn><abstract>Consistent engagement in care is associated with positive health outcomes among people living with HIV (PLWH). However, traditional retention measures ignore the evolving dynamics of engagement in care. To understand the longitudinal patterns of HIV care, we analyzed medical records from 2008 to 2015 of PLWH ≥ 18 years-old receiving care at a public, hospital-based HIV clinic (N = 2110). Using latent class analysis, we identified five distinct care trajectory classes: (1) consistent care (N = 1281); (2) less frequent care (N = 270); (3) return to care after initial attrition (N = 192); (4) moderate attrition (N = 163); and (5) rapid attrition (N = 204). The majority of PLWH in Class 1 (73.9%) had achieved sustained viral suppression (viral load ≤ 200 copies/mL at last test and &gt; 12 months prior) by study end. Among the other care classes, there was substantial variation in sustained viral suppression (61.1% in Class 2 to 3.4% in Class 5). Care trajectories could be used to prioritize re-engagement efforts.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30852729</pmid><doi>10.1007/s10461-019-02450-7</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0693-7358</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1090-7165
ispartof AIDS and behavior, 2019-09, Vol.23 (9), p.2532-2541
issn 1090-7165
1573-3254
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8944932
source Criminology Collection; Social Science Premium Collection (Proquest) (PQ_SDU_P3); Sociology Collection; Springer Link; Sociological Abstracts
subjects Adolescent
Ambulatory Care Facilities
Antiretroviral drugs
Attrition
Continuity of Patient Care
Health problems
Health Psychology
Health services
HIV
HIV Infections - drug therapy
HIV Infections - virology
Human immunodeficiency virus
Humans
Infectious Diseases
Latent Class Analysis
Longitudinal Studies
Male
Medical records
Medicine
Medicine & Public Health
Minnesota
Original Paper
Public Health
Retention
Retention in Care
Trajectories
Treatment Outcome
Viral Load
title HIV Care Trajectories as a Novel Longitudinal Assessment of Retention in Care
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T04%3A12%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=HIV%20Care%20Trajectories%20as%20a%20Novel%20Longitudinal%20Assessment%20of%20Retention%20in%20Care&rft.jtitle=AIDS%20and%20behavior&rft.au=Enns,%20Eva%20A.&rft.date=2019-09-01&rft.volume=23&rft.issue=9&rft.spage=2532&rft.epage=2541&rft.pages=2532-2541&rft.issn=1090-7165&rft.eissn=1573-3254&rft_id=info:doi/10.1007/s10461-019-02450-7&rft_dat=%3Cproquest_pubme%3E2190109717%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c474t-5170a5caafd3863ab380579c8d581569fddc060625ef095fa50cda6ac90bcc003%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2189244079&rft_id=info:pmid/30852729&rfr_iscdi=true