title: Impact of poor retention in HIV medical care on time to viral load suppression.
abstract: OBJECTIVE
  The purpose of this study was to evaluate how poor retention in HIV care impacts time to viral suppression after initiating highly active antiretroviral therapy.
  
  
  METHODS
  A retrospective cohort study design, employing a medical chart review, was conducted at an academic infectious disease clinic at the University of Kentucky. Patients seeking care between 2003 and 2011 were included in the study. A log-normal model was employed to determine the factors associated with time to viral suppression.
  
  
  RESULTS
  Of the 532 patients in the study, 426 (80.1%) patients were virally suppressed. Controlling for insurance status, race, baseline CD4 counts, and viral loads, the expected time to viral suppression for non optimal retainers was longer compared to optimal retainers (100% retained in care; time ratio: 2.04; 95% confidence interval: 1.40-2.90).
  
  
  CONCLUSIONS
  Researchers should continue to study the impact of retention on clinical outcomes and strategies to improve retention and reengage those lost to follow-up back into care.
authors.forename: Timothy N
authors.initials: TN
authors.lastname: Crawford
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Sanderson
authors.forename: Alice
authors.initials: A
authors.lastname: Thornton
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007182:Income; D007348:Insurance, Health; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured / Q000706:statistics & numerical data; D006278:Medicare; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D019562:Viral Load