Evidence map›Paper›PMID 30979728›Full record

ArticleCMAJ open

Retention in care and mortality trends among patients receiving comprehensive care for HIV infection: a retrospective cohort study.

Ana C Ulloa, Cathy Puskas, Benita Yip, Wendy Zhang, Cole Stanley, Sarah Stone, Miguel Pedromingo, Viviane Dias Lima, Julio S G Montaner, Silvia Guillemi and 1 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Retention in HIV Care Still Matters: A Longitudinal Multisite Analysis.Journal of acquired immune deficiency syndromes (1999) · 2025
    Article
  3. Article
  4. Positive Influences: How Provider Actions Affect HIV Care Engagement for Black Women in the Southwest U.S.International journal of environmental research and public health · 2025
    Article
  5. Article
  6. Article
  7. Drive time to care and retention in HIV care: Rural-urban differences among Medicaid enrollees in the United States South.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025
    Article
  8. Article
  9. Article
  10. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Ana C UlloaBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Cathy PuskasBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Benita YipBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Wendy ZhangBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Cole StanleyBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Sarah StoneBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Miguel PedromingoBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Viviane Dias LimaBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Julio S G MontanerBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Silvia GuillemiBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC.
Rolando BarriosBC Centre for Excellence in HIV/AIDS (Ulloa, Puskas, Yip, Zhang, Lima, Montaner, Guillemi, Barrios); John Ruedy Immunodeficiency Clinic (Stanley, Stone, Pedromingo), St. Paul's Hospital; Division of AIDS (Lima, Montaner), Department of Family Practice (Guillemi) and School of Population and Public Health (Barrios), University of British Columbia, Vancouver, BC rbarrios@cfenet.ubc.ca.
University of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies examining the relation between comprehensive care and health outcomes associated with comorbidities unrelated to HIV infection have focused mainly on the health outcomes of HIV-infected people and comorbid substance use disorders. We aimed to assess the impact of retention in comprehensive HIV infection care on overall, AIDS-related and non-AIDS-related mortality.

methodsUsing a retrospective cohort design, we collected data for HIV-infected patients aged 19 years or more who first visited a comprehensive HIV infection clinic in Vancouver between Jan. 1, 2004, and Dec. 31, 2014. We defined retention in care as visit constancy (whether the patient attended the clinic at least once per given period) of 75% or greater. We used Poisson regression modelling to examine mortality trends. We performed Cox proportional hazards modelling to assess survival by retention during the first year of follow-up and identify factors associated with death.

resultsA total of 2101 patients were included in the study. Of the 2101, 1340 (63.8%) were retained in the first year of care, and 271 (12.9%) died during the study period. Among the 264 cases in which the cause of death was known, although the primary underlying cause of death (74 [28.0%]) was AIDS-related, half of all AIDS-related deaths (37/74 [50%]) occurred early in the study (2004-2007). In later years, most deaths (147/184 [79.9%]) were non-AIDS-related. Overall mortality was significantly reduced among patients with higher retention in care during the first year of follow-up (per 20% increase in visit constancy; adjusted hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.79-0.96). Higher retention was also associated with reduced risk of AIDS-related death (adjusted HR 0.79, 95% CI 0.64-0.97).

interpretationAlthough there was an overall trend toward decreased AIDS-related mortality over time, retention in care markedly decreased the likelihood of death. Maintaining patient engagement in comprehensive ancillary care is a patient-centred way of decreasing mortality rates among HIV-infected people.

Identifiers

PMID30979728
PMCPMC6461542
OpenAlexW2938581949

What OpenQuestion holds

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Registered trials

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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.