Evaluating Retention in Medical Care and its Impact on the Health Outcomes of Individuals Living with Human Inmmunodeficiency Virus

摘要: OF DISSERTATION EVALUATING RETENTION TO HIV MEDICAL CARE AND ITS IMPACT ON THE HEALTH OUTCOMES INDIVIDUALS LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS In the last few years, engagement in medical care among individuals living with has become a major priority providers and public health researchers. Engagement is an important concept as it involves process of linking newly diagnosed into retaining those throughout course their infection. Although there have been advances management HIV, like advent Highly Active Antiretroviral Therapy, morbidity mortality due to cannot be fully reduced if individual does not optimally retain care. Retention emerging topic research, but still remains scarce amount research on how properly define retention, understand its predictors, impacts outcomes. The purpose this dissertation was evaluate retention seeking at urban infectious disease clinic Kentucky. three specific aims were to: (1) compare methods measuring care; (2) determine predictors poor assess effect non-HIV related comorbidities over time; (3) impact early time viral load suppression rebound initiating Therapy. A retrospective cohort study conducted employing chart review, patients who sought Bluegrass Care Clinic between January 1st 2003 May 2011 eligible for study. There 1,358 included these followed until December 31st, 2011. results suggested that should seek least once every six months (visit constancy) only 48.6% population obtained optimal time. Over rate decreased sample more likely suppress loads compared retainers.