title: Retention in HIV care among female sex workers in the Dominican Republic: implications for research, policy and programming.
abstract: There are clear benefits of retention in HIV care, yet millions of people living with HIV are sub-optimally retained. This study described factors from Andersen's behavioral model that were associated with retention in HIV care among 268 female sex workers (FSWs) living with HIV in the Dominican Republic using two measures of retention: a 6-month measure of HIV clinic attendance and a measure that combined clinic attendance and missed visits. FSWs who ever attended HIV care reported high rates (92 %) of 6-month attendance, but 37 % reported missed visits. Using the combined retention measure, the odds of being retained in HIV care were higher among FSWs with more positive perceptions of HIV service providers [adjusted odds ratio (AOR) 1.17; 95 % confidence interval (CI) 01.09, 1.25] and lower among women who reported recent alcohol consumption (AOR 0.50; 95 % CI 0.28, 0.92) and self-stigmatizing beliefs related to sex work (AOR 0.93; 95 % CI 0.88, 0.98). These findings support the hypothesis that retention in HIV care may be best determined through a combined measure as missed visits are an important mechanism to identify in-care patients who require additional support.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 904, Baltimore, MD, 21205, USA, rzulliger@jhu.edu.
authors.forename: Rose
authors.initials: R
authors.lastname: Zulliger
authors.forename: Cathy
authors.initials: C
authors.lastname: Maulsby
authors.forename: Clare
authors.initials: C
authors.lastname: Barrington
authors.forename: David
authors.initials: D
authors.lastname: Holtgrave
authors.forename: Yeycy
authors.initials: Y
authors.lastname: Donastorg
authors.forename: Martha
authors.initials: M
authors.lastname: Perez
authors.forename: Deanna
authors.initials: D
authors.lastname: Kerrigan
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D000554:Ambulatory Care Facilities; D023241:Antiretroviral Therapy, Highly Active; D001071:Appointments and Schedules; D001294:Attitude to Health; D035843:Biomedical Research; D004293:Dominican Republic; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006282:Health Personnel; D006291:Health Policy; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D060386:Sex Workers