Do Social Support, Stress, Disclosure and Stigma Influence Retention in HIV Care for Latino and African American Men Who Have Sex with Men and Women?

Wohl, Amy Rock; Galván, Frank H.; Myers, Héctor F.; Garland, Wendy; George, Sheba; Witt, Mallory D.; Cadden, Joseph; Operskalski, Eva; Jordan, Wilbert; Carpio, Félix; Lee, Martin L.

doi:10.1007/s10461-010-9833-6

Cited by 140 publications

(110 citation statements)

References 29 publications

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“…10,[34][35][36][37][38][39][40] Additionally, factors more unique to patients with HIV-infection, including stigma and HIV status disclosure, are known to affect appointment attendance. 41 These factors are not routinely measured as part of clinical care and would be difficult to operationalize.…”

Section: Discussionmentioning

confidence: 99%

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Woodward

Person²,

Rebeiro³

et al. 2015

AIDS Patient Care and STDs

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Successful treatment of HIV infection requires regular clinical follow-up. A previously published risk-prediction tool (RPT) utilizing data from the electronic health record (EHR) including medication adherence, previous appointment attendance, substance abuse, recent CD4 + count, prior antiretroviral therapy (ART) exposure, prior treatment failure, and recent HIV-1 viral load (VL) has been shown to predict virologic failure at 1 year. If this same tool could be used to predict the more immediate event of appointment attendance, high-risk patients could be identified and interventions could be targeted to improve this outcome. We conducted an observational cohort study at the Vanderbilt Comprehensive Care Clinic from August 2013 through March 2014. Patients with routine medical appointments and most recent HIV-1 VL > 200 copies/mL were included. Risk scores for a modified RPT were calculated based on data from the EHR. Odds ratios (OR) for missing the next appointment were estimated using multivariable logistic regression. Among 510 persons included, median age was 39 years, 74% were male, 55% were black, median CD4 + count was 327 cells/mm 3 [Interquartile Range (IQR): 142-560], and median HIV-1 VL was 21,818 copies/mL (IQR: 2,030-69,597). Medium [OR 3.95, 95% confidence interval (CI) 2.08-7.50, p-value < 0.01] and high (OR 9.55,, p-value < 0.01) vs. low RPT risk scores were independently associated with missing the next appointment. RPT scores, constructed using readily available data, allow for risk-stratification of HIV medical appointment non-attendance and could support targeting limited resources to improve appointment adherence in groups most at-risk of poor HIV outcomes.

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Section: Discussionmentioning

confidence: 99%

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Woodward

Person²,

Rebeiro³

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

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“…Drop-off is most dramatic among younger MSM and MSM living in lower income countries. Drop-off may be linked to inequities in access to HIV services that are in-turn driven by the relative lack of resources and social disenfranchisement [25,26]. Resource constrained countries may be investing less in their health infrastructures [27].…”

Section: Discussionmentioning

confidence: 99%

HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide

et al. 2014

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“…Disclosure has been directly associated with improved HIV virologic suppression and retention. Among a sample of 398 minority men who have sex with men (MSM) in the USA, disclosure increased the odds of retention by 50 % [25]. Similarly, in a West Africa IeDEA cohort of 650 adolescents, disclosure was associated with higher retention in care (aHR = 0.23; 95 % CI 0.13-0.39; p = 0.0001) [26].…”

Section: Social Normalizationmentioning

confidence: 98%

Understanding Sustained Retention in HIV/AIDS Care and Treatment: a Synthetic Review

et al. 2016

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Sustained retention represents an enduring and evolving challenge to HIV treatment programs in Africa. We present a theoretical framework for sustained retention borrowing from ecologic principles of sustainability and dynamic adaptation. We posit that sustained retention from the patient perspective is dependent on three foundational principles: (1) patient activation: the acceptance, prioritization, literacy, and skills to manage a chronic disease condition, (2) social normalization: the engagement of a social network and harnessing social capital to support care and treatment, and (3) livelihood routinization: the integration of care and treatment activities into livelihood priorities that may change over time. Using this framework, we highlight barriers specific to sustained retention and review interventions addressing long-term, sustained retention in HIV care with a focus on Sub-Saharan Africa.

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Do Social Support, Stress, Disclosure and Stigma Influence Retention in HIV Care for Latino and African American Men Who Have Sex with Men and Women?

Cited by 140 publications

References 29 publications

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide

Understanding Sustained Retention in HIV/AIDS Care and Treatment: a Synthetic Review

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