title: Examining the relationship between multiple comorbidities and retention in HIV medical care: a retrospective analysis.
abstract: Retention in medical care among people living with HIV (PLWH) is a major component in properly managing the disease. As PLWH age, diagnoses of comorbid conditions become common and it may be important to understand how these conditions may impact engagement in care, in particular retention in HIV medical care. A secondary data analysis was conducted to determine the relationship between multiple comorbid conditions and retention in HIV care among patients who sought HIV care between 2003 and 2011. Retention in care was defined as having two clinic visits separated by ≥3 months within a 12-month period. Logistic regression was conducted to determine if multiple comorbid conditions were associated with optimal retention (100%) versus suboptimal retention (<100%). There were 1261 patients included in the analysis, 47% had ≥1 comorbid condition, and approximately 55%, were optimally retained in care. In the regression model, those with one comorbid condition (odds ratio [OR]: 2.47; 95% confidence interval [CI]: 1.81-3.39) and ≥2 comorbid conditions (OR: 4.08; 95% CI: 2.59-6.45) were at significantly higher odds of being optimally retained in care. The results of the study suggest that those living with both HIV and multiple comorbid conditions are better engaged in care compared to those without any comorbid conditions, and this may not present a barrier to care as suggested by other researchers. The results of this study may shed light on the development of tailored interventions to improve retention in care.
authors: a School of Nursing , University of Louisville , Louisville , KY , USA.
authors: Timothy N
authors: TN
authors: Crawford
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count / Q000379:methods*; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012008:Recurrence; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: HRSA HAB performance measure; comorbid conditions; engagement in HIV care; retention in care