Crawford Timothy N
a School of Nursing , University of Louisville , Louisville , KY , USA.
AIDS Care. 2015;27(7):892-9. doi: 10.1080/09540121.2015.1009361. Epub 2015 Feb 13.
Retention in medical care among people living with HIV (PLWH) is a major component in properly managing the disease. As PLWH age, diagnoses of comorbid conditions become common and it may be important to understand how these conditions may impact engagement in care, in particular retention in HIV medical care. A secondary data analysis was conducted to determine the relationship between multiple comorbid conditions and retention in HIV care among patients who sought HIV care between 2003 and 2011. Retention in care was defined as having two clinic visits separated by ≥3 months within a 12-month period. Logistic regression was conducted to determine if multiple comorbid conditions were associated with optimal retention (100%) versus suboptimal retention (<100%). There were 1261 patients included in the analysis, 47% had ≥1 comorbid condition, and approximately 55%, were optimally retained in care. In the regression model, those with one comorbid condition (odds ratio [OR]: 2.47; 95% confidence interval [CI]: 1.81-3.39) and ≥2 comorbid conditions (OR: 4.08; 95% CI: 2.59-6.45) were at significantly higher odds of being optimally retained in care. The results of the study suggest that those living with both HIV and multiple comorbid conditions are better engaged in care compared to those without any comorbid conditions, and this may not present a barrier to care as suggested by other researchers. The results of this study may shed light on the development of tailored interventions to improve retention in care.
艾滋病毒感染者(PLWH)持续接受医疗护理是妥善管理该疾病的一个主要组成部分。随着PLWH年龄增长,合并症的诊断变得常见,了解这些病症如何影响就医参与度,尤其是艾滋病毒医疗护理的持续接受情况可能很重要。进行了一项二次数据分析,以确定2003年至2011年期间寻求艾滋病毒护理的患者中多种合并症与艾滋病毒护理持续接受情况之间的关系。护理持续接受情况定义为在12个月内有两次间隔≥3个月的门诊就诊。进行逻辑回归分析以确定多种合并症是否与最佳持续接受率(100%)与次优持续接受率(<100%)相关。分析纳入了1261名患者,47%的患者有≥1种合并症,约55%的患者实现了最佳护理持续接受。在回归模型中,患有1种合并症(优势比[OR]:2.47;95%置信区间[CI]:1.81 - 3.39)和≥2种合并症(OR:4.08;95% CI:2.59 - 6.45)的患者实现最佳护理持续接受的几率显著更高。研究结果表明,与没有任何合并症的患者相比,同时患有艾滋病毒和多种合并症的患者在接受护理方面表现更好,而且这可能并不像其他研究人员所认为的那样是护理的障碍。这项研究的结果可能有助于为制定针对性干预措施以提高护理持续接受率提供思路。