[Retention in care and distance between home and hospital in HIV patients of Buenos Aires City].

BACKGROUND

Distance from patient's home to the hospital has been proposed as one of the limiting factors for patient's retention in care.

METHODS

Retrospective cohort study of HIV+ patients 18 years or older who had their first clinical visit between 2011 and 2013 at a reference center in Buenos Aires, Argentina. Patients were considered to be retained in care if they had>=1 clinical visit, laboratory markers (VL and/or CD4 count) and/or ARVs pick-up during the year after their first clinical visit. Each patient address's latitude-longitude was obtained using Google Maps web service. Home-hospital distance and travel time were obtained with Google Maps Distance Matrix API service.

RESULTS

Of 1020 patients who started follow-up, 15 died and 158 were transferred to another site. Of the remaining, 816 (96.3%) had identifiable address in their electronic medical record. Median age at the time of the first visit was 33 (IQR 27-41) years, 654 (77.9%) patients were male. Median home-hospital distance was 10.3 (IQR 4.4-34.7) km and median travel time was 58.5 (IQR 35-102.5) minutes. 730 patients (89.5%; CI 87.1-91.5%) remained in follow-up after 1 year of their first visit. We didńt find association between travel time and home-hospital distance with retention in this population.

CONCLUSIONS

In our study, distance between home and the care center was not associated with lower retention one year after first visit in adult HIV patients attending a public hospital.