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

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Washington D.C., USA, 22-27 July 2012 www.aids2012.org 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

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Engagement in HIV care: changes with time, migration, and death. Background. Engagement estimates typically cross-sectional or at fixed interval after HIV diagnosis. Objectives. Engagement in care 18 months after HIV diagnosis. Describe the engagement cascade over time - PowerPoint PPT Presentation

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Page 1: 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

Page 2: Engagement in HIV care: changes with time, migration, and death

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

Page 3: Engagement in HIV care: changes with time, migration, and death

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

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