title: Impact of non-HIV related comorbidities on retention in HIV medical care: does retention improve over time?
abstract: The purpose of this study was to understand how the presence of comorbid conditions affects retention in HIV medical care over time. A retrospective cohort design employing a medical chart review was conducted. A generalized linear mixed model was used to determine the predictors that affect retention over time. The mean follow-up for the study population was 5.75 years, and only 48.6 % achieved optimal retention. During the study period, 882 non-HIV related comorbidities were diagnosed in 610 (44.9 %) patients of whom, approximately 31 % had ≥2 comorbidities diagnosed. In the mixed model, the number of comorbidities diagnosed during the study period was associated with improved retention over time (odds ratio = 2.28; 95 % confidence interval = 1.83-2.71). Having a non-HIV related comorbid condition was associated with improved retention, while those patients who were 'healthier' had worse retention. More research is needed to identify factors that improve retention and to quantify the impact of these factors.
authors.affiliation: Department of Epidemiology, College of Public Health, The University of Kentucky, 121 N. Martin Luther King Blvd #303, Lexington, KY, 40507, USA, tncraw2@uky.edu.
authors.forename: Timothy N
authors.initials: TN
authors.lastname: Crawford
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Sanderson
authors.forename: Patrick
authors.initials: P
authors.lastname: Breheny
authors.forename: Steven T
authors.initials: ST
authors.lastname: Fleming
authors.forename: Alice
authors.initials: A
authors.lastname: Thornton
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies
chemical_list: D019380:Anti-HIV Agents