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1 in 4 US HIV patients don't stay in care, Penn study shows
Date:3/6/2012

were all more likely to remain in care more consistently. Retention was also greater among patients whose CD4 counts the measure of how advanced the disease is were very low, at the point associated with AIDS, when they entered care.

The team suggests that their findings may help guide clinicians in assessing which patients are more likely to follow their prescribed visit schedule, and develop intervention strategies to improve their chances of adhering to their care. "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 the study's senior author and Yehia's mentor, Kelly Gebo, MD, an associate professor of Medicine at the Johns Hopkins University School of Medicine. Housing, transportation and financial problems, substance abuse and mental illness can all be contributors to problems with care retention, and patients who don't have symptoms may not believe they're "sick" enough to require regular visits with their providers.

Yehia also notes that a standardized criteria for determining the appropriate time between visits is needed, since patients who are at various stages in their disease, have other health conditions or certain social circumstances may require unique plans for care thus making it hard to assess aggregate retention across the entire HIV population. And since patients may switch doctors, move frequently, go to jail or become institutionalized and still receive care during those times, the research team suggests additional studies that track patients across those circumstances, such as research involving data from insurance records.

Questions also remain about how HIV treatment retention may change as time passes during what has become, for many, a chronic condition spanning decades of their lives.

"It's possible that as time goes by, some patients may become more regular users of care, while others may be
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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
Source:Eurekalert

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