Ingram Mercedes V, Amodei Nancy, Perez Veronica Villela, German Victor
Community Initiatives and Population Health, University Health System, 4502 Medical Dr., MS 82-2, San Antonio, TX 78229, USA.
Community Initiatives and Population Health, University Health System, San Antonio, TX, USA.
Ther Adv Infect Dis. 2022 Apr 7;9:20499361221089815. doi: 10.1177/20499361221089815. eCollection 2022 Jan-Dec.
Retention in HIV medical care is associated with improved clinical outcomes and reduced mortality. The present study was conducted to identify significant predictors of 1-year retention in care for a sample of minority women whose engagement in HIV care at baseline varied along the care continuum from newly diagnosed to lost-to-care.
One hundred sixty-five cisgender and transgender women living with HIV in a southern US state were offered a multicomponent retention intervention that included outreach, medical case management (MCM), patient navigation services (PN), and a group intervention for stigma. Multilevel logistic regression analysis was performed to identify baseline and intervention predictors of retention in care at 12 months following enrollment.
Multilevel logistic regression analysis revealed that baseline characteristics such as working significantly reduced the odds of being retained as did increasing CD4 counts. However, greater amounts of patient navigation and medical case management services received increased the odds of being retained.
MCM services designed to accelerate coordination and linkage or re-linkage to primary care and PN services to help navigate the complex system of HIV offered in the present study are particularly effective for minority women who lack health insurance, have low CD4 counts, and are unemployed.
坚持接受艾滋病医疗护理与改善临床结局及降低死亡率相关。本研究旨在为一组少数族裔女性样本确定1年护理坚持率的显著预测因素,这些女性在基线时参与艾滋病护理的情况在护理连续统一体中有所不同,从新诊断到失访。
美国南部一个州的165名感染艾滋病毒的顺性别和跨性别女性接受了一项多成分坚持干预措施,其中包括外展服务、医疗病例管理(MCM)、患者导航服务(PN)以及一项针对耻辱感的小组干预。进行多水平逻辑回归分析,以确定入组后12个月护理坚持率的基线和干预预测因素。
多水平逻辑回归分析显示,诸如工作等基线特征以及CD4计数增加均显著降低了被保留的几率。然而,获得更多的患者导航和医疗病例管理服务增加了被保留的几率。
本研究中设计用于加速与初级保健的协调及联系或重新联系以及PN服务以帮助应对复杂的艾滋病医疗系统的MCM服务,对缺乏医疗保险、CD4计数低且失业的少数族裔女性特别有效。