engagement in hiv care: changes with time, migration, and death

Engagement in HIV care: changes with time, migration, and death

• Engagement estimates typically cross-sectional or at fixed interval after HIV diagnosis

Background

Objectives• Describe the engagement cascade over time • Quantify outmigration and death • Describe effects of censoring for outmigration and death

Methods

Engagement in care 18 months after HIV diagnosis

• Retrospective cohort study • Individuals diagnosed 2005-2009, Denver Health, UC Hospital• Chart review + state health department data• Follow-up through December 31, 2010

Engagement in care over time• N=616• 76% linkage to care

in 6 mo

• Retention in care stable at 55% by 2 years

• 33%-37% had suppressed viral loads years 2-5

• By 5 years after HIV dx, 4% expired, 14% moved out of state

Engagement over time, death and migration censored

• Retention in care significantly higher when cohort censored for death and outmigration

• 48% suppressed viral loads 5 years after HIV diagnoses

• Probable underestimates given outmigration criteria and improvements in engagement in care in later years