Demographic and Clinical Factors Associated With Loss to Follow-up for HIV Primary Medical Care in the Coastal CARE Centers (Coastal Health District)

BACKGROUND: Staying in medical care is essential for HIV patients to benefit from life-saving treatment. There are limited data on predictors of retention in HIV care from rural areas of Georgia. This study is the first in Coastal Health District (CHD) to focus on lost to follow-up (LTFU) for HIV medical care and its associated factors.

METHODOLOGY: We extracted data from the electronic medical record for HIV/AIDS patients who had attended Ryan White Coastal CARE Centers (CCC) for their medical care between January 1, 2006 and October 30, 2012. We then matched the dataset with Georgia HIV Surveillance System to determine those who were LTFU (absence of CD4, viral load, and ART for 12 months). Using logistic regression analysis, we assessed demographic and clinical factors associated with LTFU for HIV care.

RESULTS: Factors associated with LTFU in the CCC were: being black/African American versus White/non-Hispanic (OR = 12.269, 95% CI: 9.034 to16.663); Being over 50 years old was three times more likely to be LTFU compared to ≤ 19 years. Having viral load < 75 copies was 2 times more likely to be LTFU compared to those with viral load 10000-99999 copies. Having CD4 Count ≥ 500 cells/mm3 (OR = 2.820, 95% CI: 1.928 to 4.123) was more likely to drop out compared to CD4 < 200 cells/mm3.

CONCLUSION: Study of factors associated with LTFU was used to identify patients at risk, and design strategies to improve retention in care and reduce HIV transmission in the Coastal Health District, Georgia.