Only about 75 percent of HIV/AIDS patients continue to seek consistent care in the U.S., according to a new nationwide study.
The study, published online in the journal AIDS, suggested the 1 in 4 HIV/AIDS patients who quit treatment face significant health risks and may pose public health risks, as well.
Investigators from the Perelman School of Medicine at the University of Pennsylvania said the study is the first to provide a comprehensive estimate of HIV care and details about patients who are most – and least -- likely to continue their treatment over time.
"Helping patients with HIV stay in care is a key way to reduce their chances of getting sick from their disease and prevent the spread of HIV in the community. Our findings show that too many patients are falling through the cracks," said lead researcher Dr. Baligh R. Yehia, an infectious disease specialist at Penn Medicine. "The benefits of keeping patients in care are clear both for patients and the community at large, and it may even result in decreased health care costs by preventing unnecessary hospitalization for an acute illness."
The researchers studied 17,425 adult patients using 12 clinics within the HIV Research Network, a consortium that cares for HIV-infected patients across the nation, between 2001 and 2008. Just 42 percent of the patients had "no gap" in treatment — intervals of no more than six months between outpatient visits — over the study period. About 31 percent had one or more seven- to 12-month gaps in care. Twenty-eight percent appeared to have gone without care for more than a year on one or more occasions.
Patients most likely to remain in care consistently tended to be women, white, older, men who have sex with men, and Medicare recipients. Patients with advanced cases of AIDS were also more likely to stay in treatment. Housing, transportation, financial problems, substance abuse, mental illness were all found to be contributing factors to patient’s dropping out. Investigators also said patients who don't have symptoms may not believe they’re "sick" enough to require regular care.
Researchers said their findings may help clinicians determine which patients are more likely to follow treatment regimens and which may require intervention strategies to retain them.
"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," said Dr. Kelly Gebo, a researcher and professor of medicine at the Johns Hopkins University School of Medicine.