Correlates of Missed Clinic Appointments Among Young Patients With HIV

Female sex, black or mixed race, drug use, and a history of incarceration are associated with poor adherence to regular clinic visits among youth patients infected with HIV, according to findings from a cross-sectional study published in AIDS Care.

A total of 2125 HIV-infected individuals between the ages of 12 and 24 years were included in this cross-sectional analysis. Investigators sought to identify interventional targets among youths living with HIV (YLH) who attended HIV clinics and who had missed a clinic visits in the last year. Within the last year, approximately 36% of participants reported missing ≥2 clinic visits.

Characteristics associated with the greatest chance of missing a clinic visit among HIV-infected youths included female sex (adjusted odds ratio [aOR], 1.63 compared with males), black or mixed racial heritage (aOR, 1.76 and 1.71, respectively, compared with white YLH), an unknown route of infection (aOR, 1.86 compared with YLH with perinatal infection), and endorsing HIV disclosure (aOR, 1.37 compared with YLH not endorsing disclosure).

In addition, participants who condoned or actively used marijuana (aOR, 1.42), were frequent users of other drugs (aOR, 1.60), or had a history of incarceration (aOR, 1.27) were at an increased risk of missing clinic visits vs youths not endorsing these health risks. Adherence support (aOR, 0.28), as well as having a strong social support network (aOR, 0.88), was associated with the greatest likelihood of regular clinic visits.

Because of the cross-sectional design, this study was only able to determine associations and not causal links between behaviors and rates of clinic visits among YLH. Also, the majority of the measures relied on patient self-report, which may have subjected the study to social desirability bias.

In addition to fostering youth-friendly environments for improving HIV care among YLH, the investigators suggest greater “efforts should be made to successfully transition young adults into adult care by reinforcing their treatment self-management skills and existing support networks, and helping them form new relationships with adult healthcare clinics and providers.”

Reference

Tarantino N, Brown LK, Whiteley L, et al; for the ATN 086 Protocol Team for the Adolescent Medicine Trials Network for HIV/AIDS Intervention. Correlates of missed clinic visits among youth living with HIV [published online February 17, 2018]. AIDS Care. doi:10.1080/09540121.2018.1437252