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764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine
BACKGROUND: Ukraine has the second largest HIV epidemic in Eastern Europe and Central Asia. Older People with HIV (OPWH) are at increased risk of poor outcomes compared to younger patients. We examined the prevalence and correlates of loss to follow-up (LTFU) among newly diagnosed patients in Ukrain...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777685/ http://dx.doi.org/10.1093/ofid/ofaa439.954 |
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author | Allen, Amy J Zeziulin, Oleksandr Postnov, Oleksandr Rozanova, Julia Litz, Taylor Zaviryukha, Irina Kiriazova, Tetiana Shenoi, Sheela |
author_facet | Allen, Amy J Zeziulin, Oleksandr Postnov, Oleksandr Rozanova, Julia Litz, Taylor Zaviryukha, Irina Kiriazova, Tetiana Shenoi, Sheela |
author_sort | Allen, Amy J |
collection | PubMed |
description | BACKGROUND: Ukraine has the second largest HIV epidemic in Eastern Europe and Central Asia. Older People with HIV (OPWH) are at increased risk of poor outcomes compared to younger patients. We examined the prevalence and correlates of loss to follow-up (LTFU) among newly diagnosed patients in Ukraine. METHODS: Retrospective chart review was conducted of 400 patients newly diagnosed with HIV July 1, 2017 - Dec 1, 2018. Data was collected from clinics in the city of Odessa and surrounding regions. OPWH were ≥50 years old at diagnosis and LTFU was defined as no contact with the HIV clinic for 90 days. Demographic, clinical characteristics, and follow-up outcomes were examined, and multivariate logistic regression was used to estimate the adjusted odds ratios at 95% confidence intervals. RESULTS: Of the 400 people living with HIV, median age was 50 (IQR35-55), 196 (49%) were women, and 177 (44%) had CD4< 200cell/mm3 at diagnosis. Overall, 65 (16.5%) were LTFU from diagnosis and 54/65 (83%) were lost after their first appointment at the HIV clinic. Among those lost to follow-up, 49 (75%) were ≥50 at the time of diagnosis. Multivariate analysis showed LTFU was associated with age >50years (aOR 3.6, CI 1.8-7.3, p=0.001), lack of ART prescription (aOR 16.4, CI 8.5-31.8, p= 0.001), and living outside the city of Odessa (aOR 2.9, CI 1.5-5.7, p=0.002). Figure 1 shows the breakdown of lost to follow-up for OPWH. Figure 1. Retainment in HIV Care for OPWH compared to those <50 years old. [Image: see text] CONCLUSION: LTFU among OPWH is significantly greater than younger people with HIV, and associated with lack of ART and living in nonurban settings. OPWH may benefit from differentiated HIV service delivery to reduce loss to follow up and interventions tailored to improving HIV outcomes for OPWH in resource-limited settings are urgently needed. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7777685 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77776852021-01-07 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine Allen, Amy J Zeziulin, Oleksandr Postnov, Oleksandr Rozanova, Julia Litz, Taylor Zaviryukha, Irina Kiriazova, Tetiana Shenoi, Sheela Open Forum Infect Dis Poster Abstracts BACKGROUND: Ukraine has the second largest HIV epidemic in Eastern Europe and Central Asia. Older People with HIV (OPWH) are at increased risk of poor outcomes compared to younger patients. We examined the prevalence and correlates of loss to follow-up (LTFU) among newly diagnosed patients in Ukraine. METHODS: Retrospective chart review was conducted of 400 patients newly diagnosed with HIV July 1, 2017 - Dec 1, 2018. Data was collected from clinics in the city of Odessa and surrounding regions. OPWH were ≥50 years old at diagnosis and LTFU was defined as no contact with the HIV clinic for 90 days. Demographic, clinical characteristics, and follow-up outcomes were examined, and multivariate logistic regression was used to estimate the adjusted odds ratios at 95% confidence intervals. RESULTS: Of the 400 people living with HIV, median age was 50 (IQR35-55), 196 (49%) were women, and 177 (44%) had CD4< 200cell/mm3 at diagnosis. Overall, 65 (16.5%) were LTFU from diagnosis and 54/65 (83%) were lost after their first appointment at the HIV clinic. Among those lost to follow-up, 49 (75%) were ≥50 at the time of diagnosis. Multivariate analysis showed LTFU was associated with age >50years (aOR 3.6, CI 1.8-7.3, p=0.001), lack of ART prescription (aOR 16.4, CI 8.5-31.8, p= 0.001), and living outside the city of Odessa (aOR 2.9, CI 1.5-5.7, p=0.002). Figure 1 shows the breakdown of lost to follow-up for OPWH. Figure 1. Retainment in HIV Care for OPWH compared to those <50 years old. [Image: see text] CONCLUSION: LTFU among OPWH is significantly greater than younger people with HIV, and associated with lack of ART and living in nonurban settings. OPWH may benefit from differentiated HIV service delivery to reduce loss to follow up and interventions tailored to improving HIV outcomes for OPWH in resource-limited settings are urgently needed. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777685/ http://dx.doi.org/10.1093/ofid/ofaa439.954 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Allen, Amy J Zeziulin, Oleksandr Postnov, Oleksandr Rozanova, Julia Litz, Taylor Zaviryukha, Irina Kiriazova, Tetiana Shenoi, Sheela 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine |
title | 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine |
title_full | 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine |
title_fullStr | 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine |
title_full_unstemmed | 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine |
title_short | 764. Correlates of Lost to Follow-up Among Newly Diagnosed Older People with HIV in Ukraine |
title_sort | 764. correlates of lost to follow-up among newly diagnosed older people with hiv in ukraine |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777685/ http://dx.doi.org/10.1093/ofid/ofaa439.954 |
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