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13th Annual Conference of the British HIV Association29 March–1 April 2007, Brighton, UK |
HIGH RATE OF LOSS TO CLINICAL FOLLOW-UP AMONG VULNERABLE HIV-INFECTED PATIENTS FROM AN INNER CITY CLINIC
HIV Med 2007; 8(Suppl. 1):7 (abstract no. O26)
Sarah Gerver1, Tim Chadborn2, Bela Vatsa2, Valerie Delpech2 and Philippa Easterbrook1
1King’s College, London, UK, 2Health Protection Agency, London, UK
OBJECTIVES: Regular clinic follow-up is important for assessing HIV treatment and other health needs and for ongoing prevention. Our aim was to determine the frequency and characteristics of patients lost to follow-up, and whether they subsequently received care elsewhere in the UK.
METHODS: All patients ≥18 years seen on ≥1 occasion at an inner city clinic from 01/1995 to 12/2004, who had not attended for ≥12 months, were matched against national SOPHID 1995–2005 data. Deceased patients were excluded. Patients who received no care elsewhere in England, Wales or Northern Ireland after leaving the clinic (LFU) were compared with those who continued their care at another site. The medical records of a random sample of LFU patients were reviewed to assess their intentions of leaving the UK.
RESULTS: Of 2257 patients registered at the clinic, 860 (38.1%) had not been seen for ≥12 months. Of these, 491 (57.1%) had not received care elsewhere (LFU), although 30.2% had been on ARV therapy and 20.4% had a CD4 <200 at their last visit. In comparison with 369 patients who continued care at another site, LFU patients were significantly more likely to be heterosexual (64.2% versus 37.1%, P<0.001%), female (41.6% versus 29.8%, P<0.001), of Black ethnicity (63.8% versus 35.2%), have received care for ≤3 months (47.1% versus 39.0%, P<0.05) and had a baseline CD4 <200 (21.4% versus 15.7%, P<0.05). 19.4% had reported plans to leave the UK.
CONCLUSION: A high proportion of HIV+ patients at an inner city HIV clinic were lost to follow-up and received no further care in the UK. Vulnerable groups and those with advanced disease were disproportionately affected. There is an urgent need to better understand the health-seeking behaviours of these patients to improve continuity of care.
2007-03-29
O26
Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD