15th Annual Conference of the British HIV Association 1-3 April 2009, Liverpool, UK

‘LOST TO FOLLOW-UP’ – WHICH PATIENTS DISENGAGE FROM HIV SERVICES AND WHY?

HIV Med 2009 Apr 1-3 (Suppl 1);15:15 (abstract no. P1)

A Osborne and S Kegg
Queen Elizabeth Hospital, London, UK

BACKGROUND: We serve an expanding and largely black African HIV population in south-east London. Our population is mobile and therefore our attrition rate is high. We sought to determine the risk factors and reasons for disengagement in the 6 months after the 2007 part 2 SOPHID census.

METHODS: Interrogation of clinic database with subsequent phone and letter contact with patients.

RESULTS: Sixty-four patients appeared on the 2007 part 2 SOPHID census but did not attend for care in the subsequent 6 months. This was more likely if the patient was black African (P=0.029) or not receiving ART (P<0.0001). However within 6 months 22/64 (34%) of these patients had returned for care. Twelve (19%) patients were accessing services elsewhere. A small number had died (3%) were overseas (3%) or in prison (7%). Of the 21 patients in whom outcomes were unknown, 14 (67%) were female, 19 (90%) were black African and 18/21 (86%) were not taking ART (CD4 range 139–645). Eleven of 21 (52%) had failed to attend for their last appointment. Twenty of21(95%) had givenconsenttophone contact,17/21 (81%) allowed letter contact and in 10/21 (48%) their GP was aware of the HIV diagnosis. Despite having no contact with HIV services 5/21 (24%) had contact with other departments in the hospital. Phone contact was successful in providing 5/20 (25%) patients with a clinic appointment. Two patients informed us that they were not accessing care elsewhere but declined an appointment. Only one patient had been out of the UK.

CONCLUSIONS: Black African patients and those not taking ART are most likely to disengage from services. Loss of contact with services or movement to other centres appears to be largely voluntary and not driven on by dispersal or deportation. A number of patients re-engage with services within 12 months and although this can be encouraged by proactive contact, mobilephonesdo not provide a durable means of contact withthese patients.

2009-04-01
P1

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