One in Four HIV Patients Don't Stay in Care

Distributed by Healthy Living News

About a quarter of HIV/AIDS patients in the United States fail to remain in care consistently, according to new research.

The study, published in the journalAIDS, is among the first in the U.S. to estimate HIV care retention.

Too many people with HIV may be falling through the cracks by not getting life saving care and treatment according to lead study author, Baligh R. Yehia, MD, of the University of Pennsylvania.

"Helping patients with HIV stay in care is a key way to reduce their chances of getting sick from their disease and prevent the spread of HIV in the community," says Dr. Yehia.

Those benefits are twofold Dr. Yehia adds. Quality care not only saves lives but it can also decrease health care costs by preventing unnecessary HIV related illnesses and hospitalizations.

Dr. Yehia's research also follows the release of a recent Center for Disease Control report showing that only about a quarter (3 out of every 4) of Americans with HIV actually have their virus under control. That makes them potentially more contagious according to a recent CDC report. One reason why is that 1 in 5 with HIV do not realize they have the virus and are therefore not on antiviral treatment. Of those who know they are infected, only half receive ongoing medical care and treatment. Of the nearly 1.2 million people living with HIV in the United States, only 28 percent have a less contagious drug suppressed viral load. Both studies illustrate that many Americans with HIV may not be accessing optimal care.

Dr Yehia's research studied 17,425 HIV infected adults at 12 U.S. clinics. Just 42 percent of patients had "no gap" in treatment - that is no more than six months in between seeing a doctor. However, 31 percent had at least one 7 to 12-month gap in care. Alarmingly, twenty-eight percent, or almost three out of ten with HIV did not access medical care for over a year.

Women, white patients, older patients, MSM, and patients on Medicare (compared to those on private insurance) remained in care more consistently. Care access was also greater among patients with more advanced HIV disease (low CD4 counts).

The researchers hope their findings will help doctors improve adherence to care by understanding which patients will or won't follow through in seeing their doctors.

"Clinicians need to know what barriers to screen for, so our findings help to better define groups of patients who may require extra help to stay on track," says study coauthor, Kelly Gebo, MD, of the Johns Hopkins University School of Medicine.

Housing, transportation and financial problems, substance abuse and mental illness hinder care retention, and patients without symptoms may believe they're not sick enough to need regular visits with a doctor.

"It's possible that as time goes by, some patients may become more regular users of care, while others may become complacent and skip appointments," Yehia says. "We need to better pinpoint times when certain patients may be less likely to remain in treatment and find ways to ensure their continued care."