Characteristics associated with retention among African American and Latino adolescent HIV-positive men: results from the outreach, care, and prevention to engage HIV-seropositive young MSM of color special project of national significance initiative.
BACKGROUND
Surveillance points to an urgent public health need for HIV prevention, access, and retention among young men of color who have sex with men (YMSM). The purpose of this multisite study was to evaluate the association between organizational- and individual-level characteristics and retention in HIV care among HIV-positive YMSM of color.


METHODS
Data were collected quarterly via face-to-face interviews and chart abstraction between June 2006 and September 2008. Participants were aged 16-24 years, enrolled at 1 of 8 participating youth-specific demonstration sites, and engaged or reengaged in HIV care within the last 30 days. Generalized estimating equations were used to examine factors associated with missing research and care visits. Stata v.9.0se was used for analysis.


RESULTS
Of 224 participants, the majority were African American (72.7%), 19-22 years old (66.5%), had graduated high school or equivalent (71.8%), identified as gay or homosexual (80.8%), and disclosed having had sex with a man before HIV diagnosis (98.2%). Over the first 2(1/4) years of the study, only 11.4% of visits were missed without explanation or patient contact. Characteristics associated with retention included being <21 years old, a history of depression, receipt of program services, and feeling respected at clinic; those associated with poorer retention included having a CD4 count <200 at baseline and being Latino.


CONCLUSIONS
Special Projects of National Significance programs were able to achieve a high level of retention over time, and individual and program characteristics were associated with retention. Latino YMSM, those not receiving services, and those not perceiving respect at the clinic were at increased risk of falling out of care. Retention is essential to providing HIV+ adolescents with treatment, including reducing antiretroviral resistance development. Innovative programs that address the needs of the YMSM of color population may result in improved retention.
Magnus
Manya
M
Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC 20037, USA. sphmdm@gwumc.edu
Jones
Karen
K
Phillips
Gregory
G
Binson
Diane
D
Hightow-Weidman
Lisa B
LB
Richards-Clarke
Candia
C
Wohl
Amy Rock
AR
Outlaw
Angulique
A
Giordano
Thomas P
TP
Quamina
Alvan
A
Cobbs
Will
W
Fields
Sheldon D
SD
Tinsley
Melinda
M
Cajina
Adan
A
Hidalgo
Julia
J
D000293:Adolescent; D001741:Black or African American; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control*; D006630:Hispanic or Latino; D006716:Homosexuality; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult; D016903:Drug Monitoring