title: Impact of Poor Retention in HIV Medical Care on Hepatitis B Vaccination.
abstract: BACKGROUND
  We identified factors associated with complete hepatitis B vaccination of patients with HIV.
  
  
  METHODS
  Retrospective analysis of patients undergoing HIV clinic orientation from 2000 to 2010. Vaccine-eligible patients had negative hepatitis B serologies at baseline. Receipt of at least 3 doses was defined as complete vaccination.
  
  
  RESULTS
  Of 1242 patients, 519 (42%) were completely vaccinated. Complete vaccination was positively associated with missing ≤25% of the visits during the first year of care (adjusted odds ratio [aOR] = 2.35, 95% confidence interval [CI]: 1.79-3.09), being naive to care (aOR = 1.50, 95% CI: 1.13-1.99), and living at the clinic's county (aOR = 1.33, 95% CI: 1.02-1.75). Complete vaccination was negatively associated with failure to remain in care >2 years (aOR = 0.18, 95% CI: 0.13-0.24), history of intravenous drug use (aOR = 0.48, 95% CI: 0.27-0.87), and baseline CD4 count <200 cells/mm(3) (aOR = 0.69, 95% CI: 0.53-0.92).
  
  
  CONCLUSIONS
  Poor retention in HIV care is strongly associated with suboptimal hepatitis B vaccination.
authors.affiliation: Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA rfranco@uab.edu.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Franco
authors.affiliation: Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tamhane
authors.affiliation: Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Edgar Turner
authors.initials: ET
authors.lastname: Overton
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006509:Hepatitis B / Q000150:complications / Q000517:prevention & control / Q000523:psychology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D014611:Vaccination / Q000523:psychology*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines
keywords: HIV/AIDS; hepatitis B vaccination; retention in medical care