Observational studyAIDS (London, England)2017
Association between engagement in-care and mortality in HIV-positive persons.
Observational study in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Antiretroviral Therapy Adherence Interventions in the Era of Universal Test and Treat: A Hybrid Systematic-Narrative Literature Review of Global Evidence.AIDS and behavior · 2026Pooled it
- Psychosocial vulnerabilities and loss to follow-up in people living with HIV in France.HIV medicine · 2026Article
- Retention in HIV care among Southeast Asian people living with HIV: A systematic review and meta-analysis.Belitung nursing journal · 2025Review
- Clients' Perspectives on Patient-Centeredness: a Qualitative Study with Low-Income Minority Women Receiving HIV Care in South Florida.Journal of racial and ethnic health disparities · 2023Article
- Antiretroviral treatment interruption and resumption within 16 weeks among HIV-positive adults in Jinan, China: a retrospective cohort study.Frontiers in public health · 2023Article
- Associations with sub-optimal clinic attendance and reasons for missed appointments among heterosexual women and men living with HIV in London.AIDS and behavior · 2022Article
- Engagement in Care Among Newly Diagnosed HIV-Positive Gay, Bisexual, and Other Men Who Have Sex With Men in the United States: Results From the Together 5,000 Study.AIDS education and prevention : official publication of the International Society for AIDS Education · 2022Article
- Measuring Unmet Needs among Persons Living with HIV at Different Stages of the Care Continuum.AIDS and behavior · 2021Article
- Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis.AIDS research and therapy · 2021Article
- Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK.HIV research & clinical practice · 2020Article
- Incidence rate, predictors and outcomes of interruption of HIV care: nationwide results from the Belgian HIV cohort.HIV medicine · 2020Article
- Article
- Sex differences in HIV treatment outcomes and adherence by exposure groups among adults in Guangdong, China: A retrospective observational cohort study.EClinicalMedicine · 2020Article
- Temporary disengagement and re-engagement in human immunodeficiency virus care in a rural county serving pastoralist communities in Kenya: a retrospective cohort study.International health · 2020Article
- Retention in HIV Care Among Participants in the Patient-Centered HIV Care Model: A Collaboration Between Community-Based Pharmacists and Primary Medical Providers.AIDS patient care and STDs · 2019Article
- Washington state satellite HIV clinic program: a model for delivering highly effective decentralized care in under-resourced communities.AIDS care · 2018Article
- Early Retention in Care Neither Mediates Nor Modifies the Effect of Sex and Sexual Mode of HIV Acquisition on HIV Survival in the Americas.AIDS patient care and STDs · 2018Article
- Equity of child and adolescent treatment, continuity of care and mortality, according to age and gender among enrollees in a large HIV programme in Tanzania.Journal of the International AIDS Society · 2018Article
- Development of an Index of Engagement in HIV Care: An Adapted Internet-Based Delphi Process.JMIR research protocols · 2017Article
- Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo assess associations between engagement in-care and future mortality.
designUK-based observational cohort study.
methodsHIV-positive participants with more than one visit after 1 January 2000 were identified. Each person-month was classified as being in or out-of-care based on the dates of the expected and observed next care visits. Cox models investigated associations between mortality and the cumulative proportion of months spent in-care (% IC, lagged by 1 year), and cumulative %IC prior to antiretroviral therapy (ART) in those attending clinic for more than 1 year, with adjustment for age, CD4/viral load, year, sex, infection mode, ethnicity, and receipt/type of ART.
resultsThe 44 432 individuals (27.8% women; 50.5% homosexual, 28.9% black African; median age 36 years) were followed for a median of 5.5 years, over which time 2279 (5.1%) people died. Higher %IC was associated with lower mortality both before [relative hazard 0.91 (95% confidence interval 0.88-0.95)/10% higher, P = 0.0001] and after [0.90 (0.87-0.93), P = 0.0001] adjustment. Adjustment for future CD4 changes revealed that the association was explained by poorer CD4 cell counts in those with lower %IC. In total 8730 participants under follow-up for more than 1 year initiated ART of whom 237 (2.7%) died. Higher values of %IC prior to ART initiation were associated with a reduced risk of mortality before [0.29 (0.17-0.47)/10%, P = 0.0001] and after [0.36 (0.21-0.61)/10%, P = 0.0002] adjustment; the association was again explained by poorer post-ART CD4/ viral load in those with lower pre-ART %IC.
conclusionsHigher levels of engagement in-care are associated with reduced mortality at all stages of infection, including in those who initiate ART.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.