The Multicenter AIDS Cohort Study: Retention after 9½ Years

Abstract

In a longitudinal, multicenter study of 4,954 men at risk for human immunodeficiency virus infection and acquired immunodeficiency syndrome, data from the first 9.5 years of follow-up (April 1984 through September 1993) were used to determine differences between those who remained in the study and those who dropped out. Demographic variables (age, race, education, employment, and study center), health status (human immunodeficiency virus type 1 serostatus and depression), and behavioral characteristics (alcohol drinking, drug use, and anal-receptive intercourse) were analyzed. Strategies for promoting retention included having frequent contact with participants, generating trust, keeping participants well-informed, utilizing multiple resources for follow-up, and providing flexible methods of participation. After 9.5 years of follow-up, vital status was known for 4,385 (88.5%) of the participants. Results from multiple logistic regression showed that race, age, education, and smoking were each significantly associated with nonparticipation (p < 0.001). A high level of retention was maintained in this well-educated and highly motivated cohort of homosexual/bisexual men. Extensive follow-up methods may improve case-finding. Nonwhite race, younger age, less education, and smoking were important predictors of dropping out. These findings identify specific groups for targeting follow-up efforts to reduce potential bias due to dropout.

Early HLA-B*57-Restricted CD8+T Lymphocyte Responses Predict HIV-1 Disease Progression

“…Established to study the natural history of HIV-1 infection, the MACS is an ongoing prospective cohort study of men who have sex with men that operates at four sites within the United States of America (19,20,22,39). Samples and information are collected from participants semiannually, with samples cryopreserved at each visit.…”

Effect of highly active antiretroviral therapy on survival among HIV‐infected men with Kaposi sarcoma or non‐Hodgkin lymphoma

“…The rationale, study protocol, recruitment and other detailed characteristics of the MACS have been described elsewhere. [15][16][17][18] The MACS prospectively examines the natural history of HIV infection in high-risk homosexual/bisexual men in four metropolitan areas in the U.S. The cohort is made up of 5,622 men who volunteered to be followed-up at least semi-annually at the four centers.…”

“…18 At each visit, the men are asked if they had been diagnosed with a malignancy since the previous visit. When a diagnosis of malignancy is reported, it is confirmed by medical record review.…”

Censoring Issues in Survival Analysis

“…September 1993, there were 4954 men between the ages of 18 and 70 who were recruited for the Multicenter AIDS Cohort Study (MACS) (5). The MACS is a longitudinal study of the natural history of human immunodeficiency virus type 1 (HIV-1) among homosexual and bisexual men.…”