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
