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Sohail M, Mugavero M, Long D, Levitan EB, Batey DS, Reed-Pickens H, Rana A, Carodine A, Nevin CR, Eady S, Parmar J, Turner K, Orakwue I, Miller T, Wynne T, Kay ES. Assessing the Impact of COVID-19 on Retention in HIV Primary Care: A Longitudinal Multisite Analysis. AIDS Behav 2022; 27:1514-1522. [PMID: 36322220 PMCID: PMC9629198 DOI: 10.1007/s10461-022-03886-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/28/2022]
Abstract
We compared retention in care outcomes between a pre-COVID-19 (Apr19-Mar20) and an early-COVID-19 (Apr20-Mar21) period to determine whether the pandemic had a significant impact on these outcomes and assessed the role of patient sociodemographics in both periods in individuals enrolled in the Data for Care Alabama project (n = 6461). Using scheduled HIV primary care provider visits, we calculated a kept-visit measure and a missed-visit measure and compared them among the pre-COVID-19 and early-COVID-19 periods. We used logistic regression models to calculated odds ratios (OR) and accompanying 95% confidence intervals (CI). Overall, individuals had lowers odds of high visit constancy [OR (95% CI): 0.85 (0.79, 0.92)] and higher odds of no-shows [OR (95% CI): 1.27 (1.19, 1.35)] during the early-COVID-19 period. Compared to white patients, Black patients were more likely to miss an appointment and transgender people versus cisgender women had lower visit constancy in the early-COVID-19 period.
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Affiliation(s)
- Maira Sohail
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
| | - Michael Mugavero
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
- UAB 1917 Clinic, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dustin Long
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
| | - Emily B Levitan
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
| | - D Scott Batey
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
| | - Harriette Reed-Pickens
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
| | - Aadia Rana
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
- UAB 1917 Clinic, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Alyssa Carodine
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States
| | - Christa R Nevin
- UAB 1917 Clinic, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Seqouya Eady
- UAB Family Clinic, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | | | | | | | | | - Emma Sophia Kay
- Center for AIDS Research (CFAR), University of Alabama at Birmingham, 10th Ave S, 35294, Birmingham, AL, United States.
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Mûnene E, Ekman B. Association between patient engagement in HIV care and antiretroviral therapy medication adherence: cross-sectional evidence from a regional HIV care center in Kenya. AIDS Care 2014; 27:378-86. [PMID: 25298265 DOI: 10.1080/09540121.2014.963020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Consistent individual effort in engagement in HIV medical services has been associated with positive health outcomes in people living with HIV (PLHIV). However, whether these benefits are facilitated by improved medication adherence has not been widely studied. This study aimed to investigate the marginal effect of engagement in HIV care on medication adherence at a public health facility in Kenya. Between February and April 2013, 392 patients on HIV care at Nyeri Provincial General Hospital participated in this study. Data were collected using a self-administered health survey questionnaire assessing health and sociodemographic statuses. A manual stepwise general linear model was specified to measure the effect of engagement in HIV and other associated predictors on medication adherence. Engagement in HIV care was significantly associated with log-transformed medication adherence in the sample (100·β = 9.2%, 95% CI 3.2-15.1) irrespective of gender and other selected predictors. Longer duration on antiretroviral therapy was also a significant predictor of better medication adherence (100·β = 3.2%, 95% CI 2.3-4.1). Despite inter-gender differences in adherence and engagement determinants, gender's independent effect on medication adherence and engagement in care were not statistically significant. Poor medication adherence was associated with lower patient engagement in HIV care services, suggesting that interventions which remove obstacles to regular observance of scheduled clinic appointments and eventual retention may have a beneficial impact on medication adherence and, accordingly, health outcomes in PLHIV.
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Affiliation(s)
- Edwin Mûnene
- a Department of Pharmacy , Nyeri Provincial General Hospital , Nyeri , Nyeri County , Kenya
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