Amsterdam 2015
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| Abstract #2109 - Challenging situations | ||||
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Session: 53.1: Challenging situations (Parallel) on Friday @ 11.00-12.30 in C002 Chaired by Heidi van Rooyen, Rich Wolitski Authors: Presenting Author: Dr Jenny Petrak - Homerton Sexual Health Services, United Kingdom |
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| Additional Authors: | ||||
| Aim: Background: One in five persons living with HIV is lost to follow-up (LTFU) from care in the UK. This can lead to serious health consequences and increased onward transmission. Previous studies have identified factors such as gender, younger age, ethnicity, not receiving ART, and being newly diagnosed as being implicated in LTFU (HPA, 2011). There is little data to inform the relationship of psychosocial difficulties on retention in care. We aimed to examine factors after new diagnosis of HIV infection associated with engagement in care. | ||||
| Method / Issue: Method: Persons newly diagnosed with HIV infection in this London clinic are offered initial screening with a modified Client Diagnostic Questionnaire (mCDQ). The mCDQ includes standard questionnaires for anxiety, depression, PTSD, and substance misuse. All new diagnoses (2010-2013) were analysed for subsequent attendance patterns from electronic patient records. LTFU was defined as non-attendance for more than one year following diagnosis (LTFU1) or non-attendance for a year following initial 3 month engagement (LTFU2). Patients who missed >3 medical appointments in a year were recorded as incomplete attenders. Attendance was reviewed using electronic and paper records. CDQ scores were examined in relation to subsequent attendance and referral patterns. | ||||
| Results / Comments: Results: 316 newly diagnosed patients were seen in the service between January 2010 and January 2014. 16/316 (5%) were LTFU1, 11 (3%) were LTFU2, 76 (24%) were incomplete attenders, 174 (55%) were regular attenders, 33 (10%) transferred care in their first year, and 6(2%) died. Patients LTFU did not differ significantly in gender, sexuality or ethnicity. Younger age was associated with LTFU compared to those retained in care (p=.05). Significant differences were found in distribution of CD4 counts with those lost to follow up immediately after diagnosis (LTFU1) less likely to have a CD4 count over 350 compared to those in LTFU2 group (p<.001). LTFU groups also differed in their route of exposure (p=.01) with more people recorded as intravenous drug users (7% of those LFU compared to 1% of those retained in care). Persons completing the mCDQ (n=123) were less likely to become LTFU compared to those who did not complete the mCDQ (n=154) (p=.01). Being LTFU was not significantly associated with screening positive on the mCDQ. | ||||
| Discussion: Discussion: Overall 14% of patients newly diagnosed with HIV infection over the period 2010 - 2013 were LTFU in this hospital setting. Screening for psychosocial difficulties after diagnosis with the mCDQ was associated with retention in care possibly due to increased referral and enhanced engagement in care. Further prospective studies may contribute towards engagement strategies for individuals who are at risk of becoming lost to follow-up. 1. Health Protection Agency. HIV in the United Kingdom: 2011 Report. London: Health Protection Services, Colindale. November 2011. | ||||
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