Risk factors in an HIV-infected population for refraining from specialist care

Area of Science:

• Medical Science
• Public Health
• HIV/AIDS Research

Background:

• Maintaining medical care is crucial for combination antiretroviral therapy (cART) effectiveness in HIV patients.
• Missed clinical visits are linked to increased all-cause mortality in individuals with HIV.
• Understanding nonattendance factors is key to improving patient retention in care.

Purpose of the Study:

• To identify risk factors associated with missed outpatient clinic appointments among HIV-infected patients.
• To determine patient-reported reasons for nonattendance at HIV clinics.
• To explore potential interventions for improving appointment adherence.

Main Methods:

• A cross-sectional case-control study involving 447 HIV-infected patients was conducted.
• Cases (missed appointments) were compared to controls (no missed appointments) using clinical records and questionnaires.
• Multivariable logistic regression analyzed independent risk factors for nonattendance.

Main Results:

• Younger age (<30), African origin, having young children, and history of substance abuse were significant risk factors for missed appointments.
• Patients not on cART or with high viral load (>400 copies/ml) were more likely to miss visits.
• Forgetting appointments was the primary reason for nonattendance, with most patients preferring SMS reminders.

Conclusions:

• Missed outpatient clinic appointments correlate with specific clinical and demographic characteristics.
• Implementing routine SMS appointment reminders could significantly reduce nonattendance rates.
• Improving patient retention in care is essential for optimizing HIV treatment outcomes.