title: Factors Associated With Retention Among Non-Perinatally HIV-Infected Youth in the HIV Research Network.
abstract: BACKGROUND
  The transmission of human immunodeficiency virus (HIV) among youth through high-risk behaviors continues to increase. Retention in Care is associated with positive clinical outcomes and a decrease in HIV transmission risk behaviors. We evaluated the clinical and demographic characteristics of non-perinatally HIV (nPHIV)-infected youth associated with retention 1 year after initiating care and in the 2 years thereafter. We also assessed the impact retention in year 1 had on retention in years 2 and 3.
  
  
  METHODS
  This was a retrospective analysis of treatment-naive nPHIV-infected 12- to 24-year-old youth presenting for care in 16 US HIV clinical sites within the HIV Research Network between 2002 and 2008. Multivariate logistic regression identified factors associated with retention.
  
  
  RESULTS
  Of 1160 nPHIV-infected youth, 44.6% were retained in care during the first year, and 22.4% were retained in all 3 years. Retention in the first year was associated with starting antiretroviral therapy in the first year (adjusted odds ratio [AOR], 3.47 [95% confidence interval (CI), 2.57-4.67]), Hispanic ethnicity (AOR, 1.66 [95% CI, 1.08-2.56]), men who have sex with men (AOR, 1.59 [95% CI, 1.07-2.36]), and receiving care at a pediatric site (AOR, 5.37 [95% CI, 3.20-9.01]). Retention in years 2 and 3 was associated with being retained 1 year after initiating care (AOR, 7.44 [95% CI, 5.11-10.83]).
  
  
  CONCLUSIONS
  A high proportion of newly enrolled nPHIV-infected youth were not retained for 1 year, and only 1 in 4 were retained for 3 years. Patients who were Hispanic, were men who have sex with men, or were seen at pediatric clinics were more likely to be retained in care. Interventions that target those at risk of being lost to follow up are essential for this high-risk population.
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Charles
authors.initials: C
authors.lastname: Farmer
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
authors.forename: Baligh R
authors.initials: BR
authors.lastname: Yehia
authors.affiliation: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland.
authors.forename: John A
authors.initials: JA
authors.lastname: Fleishman
authors.affiliation: Division of General Pediatrics, Children's Hospital of Philadelphia, Pennsylvania.
authors.forename: Richard
authors.initials: R
authors.lastname: Rutstein
authors.affiliation: Department of Clinical Medicine, University of California San Diego Medical Center.
authors.forename: W Christopher
authors.initials: WC
authors.lastname: Mathews
authors.affiliation: Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Ank
authors.initials: A
authors.lastname: Nijhawan
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Agwu
mesh_terms: D000293:Adolescent; D002648:Child; D003695:Delivery of Health Care; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000635:transmission*; D018451:Homosexuality, Male; D006776:Hospitals, Pediatric; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: HIV Research Network; adolescents; retention; youth