Characteristics Associated With Retention Among African American and Latino Adolescent HIV-Positive Men: Results From the Outreach, Care, and Prevention to Engage HIV-Seropositive Young MSM of Color Special Project of National Significance Initiative
Characteristics Associated With Retention Among African American and Latino Adolescent HIV-Positive Men: Results From the Outreach, Care, and Prevention to Engage HIV-Seropositive Young MSM of Color Special Project of National Significance Initiative
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DOI：
10.1097/qai.0b013e3181b56404
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发表时间：
2010-04-01
影响因子：
3.6
通讯作者：
Hidalgo, Julia
中科院分区：
文献类型：
--
作者：
Magnus, Manya;Jones, Karen;Hidalgo, Julia
背景：监测表明，在有色人种男男性行为青年（YMSM）中预防、获取和保留艾滋病毒是一项迫切的公共卫生需求。本多地点研究的目的是评估组织和个人水平的特征与艾滋病毒阳性的有色YMSM在艾滋病毒护理中的保留之间的关系。方法：2006年6月- 2008年9月，每季度采用面对面访谈和图表抽象化的方法收集资料。参与者年龄在16-24岁之间，在8个参与青年示范站点中的1个注册，并在过去30天内从事或重新从事艾滋病毒护理。使用广义估计方程来检查与缺失研究和护理访问相关的因素。采用Stata v.9.0se进行分析。结果：在224名参与者中，大多数是非裔美国人（72.7%），19-22岁（66.5%），高中毕业或同等学历（71.8%），确定为同性恋（80.8%），并在艾滋病诊断前披露与男性发生过性行为（98.2%）。在前2(1)/(4)年的研究中，只有11.4%的患者在没有解释或患者联系的情况下错过了就诊。与保留相关的特征包括年龄< 21岁，有抑郁史，接受过项目服务，在诊所感到受到尊重；与较差的滞留率相关的包括基线CD4计数< 200和拉丁裔。结论：随着时间的推移，国家重大专项项目能够实现高水平的保留率，个人和项目特征与保留率有关。拉丁裔YMSM，那些没有接受服务的人，以及那些在诊所没有感受到尊重的人，失去护理的风险增加。保留对向艾滋病毒阳性青少年提供治疗至关重要，包括减少抗逆转录病毒耐药性的发展。解决有色人种的YMSM需求的创新方案可能会提高保留率。
Background: Surveillance points to an urgent public health need for HIV prevention, access, and retention among young men of color who have sex with men (YMSM). The purpose of this multisite study was to evaluate the association between organizational- and individual-level characteristics and retention in HIV care among HIV-positive YMSM of color.Methods: Data were collected quarterly via face-to-face interviews and chart abstraction between June 2006 and September 2008. Participants were aged 16-24 years, enrolled at 1 of 8 participating youth-specific demonstration sites, and engaged or reengaged in HIV care within the last 30 days. Generalized estimating equations were used to examine factors associated with missing research and care visits. Stata v.9.0se was used for analysis.Results: Of 224 participants, the majority were African American (72.7%), 19-22 years old (66.5%), had graduated high school or equivalent (71.8%), identified as gay or homosexual (80.8%), and disclosed having had sex with a man before HIV diagnosis (98.2%). Over the first 2(1)/(4) years of the study, only 11.4% of visits were missed without explanation or patient contact. Characteristics associated with retention included being < 21 years old, a history of depression, receipt of program services, and feeling respected at clinic; those associated with poorer retention included having a CD4 count < 200 at baseline and being Latino.Conclusions: Special Projects of National Significance programs were able to achieve a high level of retention over time, and individual and program characteristics were associated with retention. Latino YMSM, those not receiving services, and those not perceiving respect at the clinic were at increased risk of falling out of care. Retention is essential to providing HIV+ adolescents with treatment, including reducing antiretroviral resistance development. Innovative programs that address the needs of the YMSM of color population may result in improved retention.