Factors Affecting Adherence With Follow-up Appointments in HIV Patients

• Authors: Katie A O'Connell, Eastern Virginia Medical School; Shaheer Sherani, Eastern Virginia Medical School; Alice Kisteneff, Eastern Virginia Medical School; Karthik Bhat, Emory University; Jarrett Slater, Eastern Virginia Medical School; Christian F Klein, Eastern Virginia Medical School; Brent Lavey, Eastern Virginia Medical School; Ashlee Malone, Eastern Virginia Medical School; Rehan Qayyum, Eastern Virginia Medical School; Catherine J Derber, Eastern Virginia Medical School
• Journal Title: Cureus
• Volume: Volume 14, Number 9
• Publisher: Cureus, Inc. | 2022-09-21
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.7759/cureus.29424
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: follow-up appointment; uncontrolled hiv; hiv viral load; adherence to therapy; hiv care

Abstract

Currently, the majority of new human immunodeficiency virus (HIV) infections are transmitted by individuals with untreated HIV. In this retrospective study, we examined associations between demographic factors, viral suppression, acquired immunodeficiency syndrome (AIDS) status (CD4 count <200), and adherence to clinical follow-up in individuals living with HIV. Of the 489 patients, 135 (27.6%) were females, 235 (48.1%) were over 50 years old, 191 (39.1%) had Medicaid, Medicare, or Ryan White Insurance, 25 (5.1%) had CD4 counts below 200, and 207 (42.3%) were adherent to their clinic appointments. In univariable logistic regression analysis, age and viral load detectability were significantly associated with patient adherence to their clinic appointment. In multivariable analysis, only age remained significantly associated with clinic appointment adherence (Odds Ratio=2.1; 95% Confidence Interval=1.4, 3.1; P<0.001). Patients 50 years old or younger were half as likely to be adherent to their clinic appointments than patients over 50 years old. Gender and insurance status were not associated with viral suppression or AIDS status. The results illustrate the need for increased age-specific outreach to improve clinical adherence in younger individuals.