ArticleAIDS (London, England)2018
Beyond binary retention in HIV care: predictors of the dynamic processes of patient engagement, disengagement, and re-entry into care in a US clinical cohort.
Article in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- HIV continuum of care: expanding scope beyond a cross-sectional view to include time analysis: a systematic review.BMC public health · 2021Pooled it
- The effect of tracer contact on return to care among adult, "lost to follow-up" patients living with HIV in Zambia: an instrumental variable analysis.Journal of the International AIDS Society · 2021Trial
- A Multistate Analysis of Longitudinal Care Outcomes Among People Newly Linked to Human Immunodeficiency Virus Care in Missouri.Open forum infectious diseases · 2026Article
- Clinical and HIV Surveillance Data to Determine Care Status for People With HIV in Washington, DC.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Progress of HIV care cascade and transition dynamics along the continuum of care among persons living with HIV in Ifakara, Tanzania: a prospective study.BMC infectious diseases · 2026Article
- Tracing the journey: Patient engagement in long-term antiretroviral therapy care in Malawi.PloS one · 2026Article
- Appraising the HIV prevention cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe.PLOS global public health · 2026Article
- Engaging Diverse African American/Black and Latine Youth and Emerging Adults Living with HIV into Research: Description of Recruitment Strategies and Lessons Learned.AIDS and behavior · 2025Article
- St. Louis enhancing engagement and retention (STEER) in HIV/AIDS care: a participatory intersectional needs assessment for intervention and implementation planning.Frontiers in public health · 2025Article
- Article
- 'Not taking medications and taking medication, it was the same thing:' perspectives of antiretroviral therapy among people hospitalised with advanced HIV disease.BMC infectious diseases · 2024Article
- Frequent Disengagement and Subsequent Mortality Among People With HIV and Hepatitis C in Canada: A Prospective Cohort Study.Open forum infectious diseases · 2024Article
- Article
- Statistical methods applied for the assessment of the HIV cascade and continuum of care: a systematic scoping review.BMJ open · 2023Article
- The Effect of HIV Treatment Interruption on Subsequent Immunological Response.American journal of epidemiology · 2023Article
- Trajectories of re-engagement: factors and mechanisms enabling patient return to HIV care in Zambia.Journal of the International AIDS Society · 2023Article
- Relationship between Housing Characteristics and Care Outcomes among Women Living with HIV: Latent Class Analysis.Social work research · 2022Article
- Site-Level Comprehensiveness of Care Is Associated with Individual Clinical Retention Among Adults Living with HIV in International Epidemiology Databases to Evaluate AIDS, a Global HIV Cohort Collaboration, 2000-2016.AIDS patient care and STDs · 2022Article
- Cyclical Engagement in HIV Care: A Qualitative Study of Clinic Transfers to Re-enter HIV Care in Cape Town, South Africa.AIDS and behavior · 2022Article
- HIV PrEP is more than ART-lite: Longitudinal study of real-world PrEP services data identifies missing measures meaningful to HIV prevention programming.Journal of the International AIDS Society · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesStudies examining engagement in HIV care often capture cross-sectional patient status to estimate retention and identify predictors of attrition, which ignore longitudinal patient care-seeking behaviors. We describe the cyclical nature of (dis)engagement and re-entry into HIV care using the state transition framework.
designWe represent the dynamic patterns of patient care-retention using five states: engaged in care, missed one, two, three, or more expected visits, and deceased. Then we describe various care-seeking behaviors in terms of transitioning from one state to another (e.g. from disengaged to engaged). This analysis includes 31 009 patients enrolled in the Center for AIDS Research Network of Integrated Systems (CNICS) in the United States from 1996 to 2014.
methodMultistate models for longitudinal data were used to identify barriers to retention and subgroups at higher risk of falling out of care.
resultsThe initial 2 years following primary engagement in care were a crucial time for improving retention. Patients who had not initiated antiretroviral therapy, with lower CD4 cell counts, higher viral load, or not having an AIDS-defining illness were less likely to be retained in care.
conclusionBeyond the individual patient characteristics typically used to characterize retention in HIV care, we identified specific periods of time and points in the care continuum associated with elevated risk of transitioning out of care. Our findings can contribute to evidence-based recommendations to enhance long-term retention in CNICS. This approach can also be applied to other cohort data to identify retention strategies tailored to each population.
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