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Engagement Trends in HIV Care: Time, Migration, and Mortality Impact

Explore the evolution of engagement in HIV care over time, including outmigration and death effects, through a retrospective study in Denver. Assessing engagement levels, viral load suppression, and the impact of censoring for accurate data analysis.

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Engagement Trends in HIV Care: Time, Migration, and Mortality Impact

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  1. Engagement in HIV care: changes with time, migration, and death Background • Engagement estimates typically cross-sectional or at fixed interval after HIV diagnosis Objectives Engagement in care 18 months after HIV diagnosis • Describe the engagement cascade over time • Quantify outmigration and death • Describe effects of censoring for outmigration and death Methods • Retrospective cohort study • Individuals diagnosed 2005-2009, Denver Health, UC Hospital • Chart review + state health department data • Follow-up through December 31, 2010

  2. Engagement in care over time • N=616 • 76% linkage to care in 6 mo • Retention in care stable at 55% by 2 years • 33%-37% had suppressed viral loads years 2-5 • By 5 years after HIV dx, 4% expired, 14% moved out of state

  3. Engagement over time, death and migration censored • Retention in care significantly higher when cohort censored for death and outmigration • 48% suppressed viral loads 5 years after HIV diagnoses • Probable underestimates given outmigration criteria and improvements in engagement in care in later years

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