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Retention in HIV Care Still Matters: A Longitudinal Multisite Analysis
Emma Sophia Kay1, John R Bassler2, Melanie C Goebel3
1School of Nursing, University of Alabama at Birmingham, Birmingham, AL.
Journal of Acquired Immune Deficiency Syndromes (1999)
|June 18, 2025
Summary
Retention in care is crucial for sustained viral suppression in people with HIV (PWH). Consistent engagement with healthcare services remains a key indicator for improving HIV health outcomes.
Area of Science:
- Infectious Diseases
- Public Health
- Clinical Medicine
Background:
- Retention in care for people with HIV (PWH) is a debated metric, especially with advanced antiretroviral therapy (ART).
- The study investigates the link between retention and sustained viral suppression (SVS) in PWH.
Purpose of the Study:
- To assess the relationship between retention in care and sustained viral suppression (SVS) over two years.
- To compare this relationship in newly established versus previously established PWH.
Main Methods:
- Analysis of data from seven Center for AIDS Research Network of Integrated Clinical Systems (CNICS) sites.
- Categorization of PWH into newly established (2017, ART-naïve) and previously established cohorts.
- Measurement of retention using visit-based metrics and SVS defined as viral load ≤200 copies/mL.
Main Results:
- A higher proportion of previously established patients achieved retention and SVS compared to newly established patients.
- Retention in care, measured by both kept and missed visits, predicted SVS in both cohorts.
- These findings held true after controlling for demographic and risk factors.
Conclusions:
- Retention in care remains a clinically significant metric for all PWH.
- Consistent engagement in HIV care is vital for achieving sustained viral suppression.
- National HIV/AIDS strategies should re-emphasize retention as a key performance indicator.
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