Retention in care, viral suppression higher in Ryan White HIV/AIDS Program clients
The rates of retention in care and viral suppression are higher among patients receiving care funded by the Ryan White HIV/AIDS Program vs. other national estimates, but researchers with the HIV/AIDS Bureau of the Health Resources and Services Administration suggest that there is still room for improvement.
“Improving these outcomes among the remaining clients will require dedicated resources and attention,” the researchers wrote in Clinical Infectious Diseases. “Retention in HIV medical care and viral suppression are two of the main goals of the National HIV/AIDS Strategy and the Presidential Executive Order – HIV Care Continuum. Improvements … among Ryan White HIV/AIDS Program clients will contribute towards bringing the United States closer to an AIDS-free generation.”
Grantees and providers of the Ryan White HIV/AIDS Program have reported data on demographics, services and clinical information annually since 2010. The researchers used this data to identify patients who received outpatient, ambulatory HIV medical care funded by the Ryan White HIV/AIDS Program in 2011 and calculate retention in care and viral suppression. An estimated 512,911 patients with HIV received services funded by the Ryan White HIV/AIDS Program, and among those, 317,458 (61.8%) received funded HIV medical care.
Among the 276,067 patients who had at least one funded HIV medical care visit and had visit dates available, 226,996 (82.2%) had at least two HIV medical care visits at least 90 days apart. In a multivariate analysis, age, race/ethnicity, gender and payer source were associated with retention in care.
There were 264,488 patients who had at least one funded HIV medical care visit and viral load measurements available; 72.6% of these patients achieved viral suppression. In a multivariate analysis, age, gender, race/ethnicity, payer source and retention status were associated with viral suppression. The strongest association was with retention in HIV care (OR=2.4; 95% CI, 2.34-2.46).
“We found the lowest rates of retention and viral suppression in age groups 13-18 years, 19-24 years and 25-34 years, and the widest gap between retention and viral suppression was among 19- to 24-year-olds,” the researchers wrote. “These findings suggest that there may be an extended period of poor engagement with HIV medical care that persists from adolescence into young adulthood.”
Disclosure: The researchers report no relevant financial disclosures.