title: The Role of Early HIV Status Disclosure in Retention in HIV Care.
abstract: The objective of this study was to evaluate whether nondisclosure or selective disclosure of HIV status to others is associated with retention in HIV care. This retrospective analysis evaluated the relationship of self-reported disclosure of HIV status as an indicator for poor retention in care (a gap in care >180 days) during the 12 months following initial entry into HIV care. Nondisclosure (disclosure to no one) and selective disclosure were compared to broad disclosure (referent). Univariate and multivariable (MV) logistic regression models were fit, including factors known to be associated with disclosure and retention in care. From 2007 to 2013, 508 HIV-infected patients presented to initiate care, of whom 63% were black, 54% had a CD4 + T lymphocyte count <350, and 82% were men (60% of whom were men who have sex with other men). Of these, 65 (13%) reported nondisclosure, 258 (49%) reported selective disclosure, and 185 (38%) reported broad disclosure. In MV analyses, nondisclosure was associated with poor retention in care (AOR 2.2; 95% CI 1.2, 4.2). Evaluating disclosure patterns among patients establishing HIV care may help predict and prevent inconsistent care. Further work is needed to understand the relationship between disclosure and retention in care in order to guide future interventions to improve HIV-outcomes.
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Latesha
authors.initials: L
authors.lastname: Elopre
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Hook
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Westfall
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Anne
authors.initials: A
authors.lastname: Zinski
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.affiliation: 2 Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Janet
authors.initials: J
authors.lastname: Turan
authors.affiliation: 1 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Van Wagoner
mesh_terms: D000293:Adolescent; D000328:Adult; D000407:Alabama / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D012189:Retrospective Studies; D012309:Risk-Taking; D012650:Self Disclosure; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents