Journal article
The Impact of Age on Retention in Care and Viral Suppression
Journal of acquired immune deficiency syndromes (1999), Vol.68(4), pp.413-419
04/01/2015
DOI: 10.1097/QAI.0000000000000489
PMCID: PMC4334738
PMID: 25559604
Abstract
Background: Retention in care is important for all HIV-infected persons and is strongly associated with initiation of antiretroviral therapy and viral suppression. However, it is unclear how retention in care and age interact to affect viral suppression. We evaluated whether the association between retention and viral suppression differed by age at entry into care.
Methods: Cross-sectional analysis (2006-2010) involving 17,044 HIV-infected adults in 14 clinical cohorts across the United States and Canada. Patients contributed 1 year of data during their first full-calendar year of clinical observation. Poisson regression examined associations between retention measures [US National HIV/AIDS Strategy (NHAS), US Department of Health and Human Services (DHHS), 6-month gap, and 3-month visit constancy] and viral suppression (HIV RNA ≤200 copies/mL) by age group: 18-29 years, 30-39 years, 40-49 years, 50-59 years, and 60 years or older.
Results: Overall, 89% of patients were retained in care using the NHAS measure, 74% with the DHHS indicator, 85% did not have a 6-month gap, and 62% had visits in 3-4 quarters of the year; 54% achieved viral suppression. For each retention measure, the association with viral suppression was significant for only the younger age groups (18-29 and 30-39 years): 18-29 years [adjusted prevalence ratio (APR) = 1.33, 95% confidence interval (CI): 1.03 to 1.70]; 30-39 years (APR = 1.23, 95% CI: 1.01 to 1.49); 40-49 years (APR = 1.06, 95% CI: 0.90 to 1.22); 50-59 (APR = 0.92, 95% CI: 0.75 to 1.13); ≥60 years (APR = 0.99, 95% CI: 0.63 to 1.56) using the NHAS measure as a representative example.
Conclusions: These results have important implications for improving viral control among younger adults, emphasizing the crucial role retention in care plays in supporting viral suppression in this population.
Details
- Title: Subtitle
- The Impact of Age on Retention in Care and Viral Suppression
- Creators
- Baligh R Yehia - University of Pennsylvania, Philadelphia, PAPeter Rebeiro - Johns Hopkins University, Baltimore, MDKeri N Althoff - Johns Hopkins University, Baltimore, MDMichael A Horberg - Kaiser Permanente Mid-Atlantic States, Rockville, MDHasina Samji - British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, CanadaSonia Napravnik - University of North Carolina, Chapel Hill, NCKenneth Mayer - The Fenway Institute, Boston MAEllen Tedaldi - Temple University, Philadelphia, PAMichael J Silverberg - Kaiser Permanente Northern California, Oakland, CAJennifer E Thorne - Johns Hopkins University, Baltimore, MDAnn N Burchell - Ontario HIV Treatment Network, Toronto, ON, CanadaSean B Rourke - Ontario HIV Treatment Network, Toronto, ON, CanadaAnita Rachlis - Ontario HIV Treatment Network, Toronto, ON, CanadaAngel Mayor - Universidad Central del Caribe, Bayamon, PRM. John Gill - University of Calgary, Calgary, AB, CanadaAnne Zinski - University of Alabama at Birmingham, Birmingham, ALMichael Ohl - Iowa City Veterans Affairs Medical Center, Iowa City, IAKathryn Anastos - Montefiore Medical Center, Bronx, NYAlison G Abraham - Johns Hopkins University, Baltimore, MDMari M Kitahata - University of Washington, Seattle, WARichard D Moore - Johns Hopkins University, Baltimore, MDKelly A Gebo - Johns Hopkins University, Baltimore, MDNorth American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
- Resource Type
- Journal article
- Publication Details
- Journal of acquired immune deficiency syndromes (1999), Vol.68(4), pp.413-419
- DOI
- 10.1097/QAI.0000000000000489
- PMID
- 25559604
- PMCID
- PMC4334738
- NLM abbreviation
- J Acquir Immune Defic Syndr
- ISSN
- 1525-4135
- eISSN
- 1944-7884
- Language
- English
- Date published
- 04/01/2015
- Academic Unit
- Psychiatry; Internal Medicine
- Record Identifier
- 9984094522602771
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