Cohen Jenny K, Santos Glenn-Milo, Moss Nicholas J, Coffin Phillip O, Block Nikolas, Klausner Jeffrey D
a Department of Internal Medicine , University of California , San Francisco , CA , USA.
b Center for Public Health Research, San Francisco Department of Public Health , San Francisco , CA , USA.
AIDS Care. 2016;28(5):579-84. doi: 10.1080/09540121.2015.1118431. Epub 2015 Dec 11.
Although poor clinic attendance is associated with increased morbidity and mortality among HIV-infected individuals, less is known about predictors of retention and the acceptability of targeted interventions to increase regular clinic attendance. To better understand which patients are at risk for irregular clinic attendance and to explore interventions to aid in retention to care, we surveyed patients attending two outpatient HIV clinics affiliated with the University of California, San Francisco. A total of 606 participants were surveyed, and the analysis was restricted to the 523 male respondents. Of this group, 45% (N = 299) reported missing at least one visit a year. Missing a clinic visit was associated with being African American (aOR = 1.99; 95%CI 1.12-3.52), being a man who has sex with both men and women (aOR=2.72; 95%CI 1.16-6.37), and reporting at least weekly methamphetamine use (aOR=5.79; 95%CI 2.47-13.57). Participants who reported a monthly income greater than $2000 were less likely to miss an appointment (aOR = 0.56; 95%CI 0.34-0.93). Regarding possible retention interventions, most patients preferred phone calls over other forms of support. These findings support the need for ongoing engagement support with particular attention to at-risk sub-groups.
尽管就诊不规律与艾滋病毒感染者发病率和死亡率的增加有关，但对于影响留存率的预测因素以及提高定期就诊率的针对性干预措施的可接受性，我们所知甚少。为了更好地了解哪些患者有就诊不规律的风险，并探索有助于维持治疗的干预措施，我们对加州大学旧金山分校附属的两家门诊艾滋病毒诊所的患者进行了调查。总共对606名参与者进行了调查，分析仅限于523名男性受访者。在这组受访者中，45%（N = 299）报告每年至少错过一次就诊。错过就诊与非裔美国人身份（调整后比值比[aOR]=1.99；95%置信区间[CI] 1.12 - 3.52）、与男性和女性都发生性行为的男性身份（aOR = 2.72；95%CI 1.16 - 6.37）以及报告至少每周使用甲基苯丙胺（aOR = 5.79；95%CI 2.47 - 13.57）有关。报告月收入超过2000美元的参与者错过预约的可能性较小（aOR = 0.56；95%CI 0.34 - 0.93）。关于可能的留存干预措施，大多数患者更喜欢通过电话获得支持，而不是其他形式的支持。这些发现支持了持续提供参与支持的必要性，尤其要关注高危亚组。
