Universidad Peruana Cayetano Heredia

Early Retention in Care Neither Mediates Nor Modifies the Effect of Sex and Sexual Mode of HIV Acquisition on HIV Survival in the Americas

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dc.contributor.author Coelho, Lara
dc.contributor.author Rebeiro, Peter F.
dc.contributor.author Castilho, Jessica L.
dc.contributor.author Caro-Vega, Yanink
dc.contributor.author Mejía Cordero, Fernando Alonso
dc.contributor.author Cesar, Carina
dc.contributor.author Cortes, Claudia P.
dc.contributor.author Padgett, Denis
dc.contributor.author McGowan, Catherine C.
dc.contributor.author Veloso, Valdiléa G.
dc.contributor.author Sterling, Timothy R.
dc.contributor.author Grinsztejn, Beatriz
dc.contributor.author Shepherd, Bryan E.
dc.contributor.author Luz, Paula M.
dc.date.accessioned 2018-10-10T23:27:54Z
dc.date.available 2018-10-10T23:27:54Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/3879
dc.description.abstract Early retention in care, sex, and sexual mode of HIV acquisition has been associated with mortality risk among persons living with HIV (PLWH). We assessed whether early retention in care mediates or modifies the association between mortality and sex and sexual mode of HIV acquisition among PLWH on antiretroviral therapy (ART) in the Americas. ART-naïve, adult PLWH (≥18 years) enrolling at Caribbean, Central and South America network for HIV epidemiology (CCASAnet) and Vanderbilt Comprehensive Care Clinic sites 2000–2015, starting ART, and with ≥1 visit after ART-start were included. Early retention in care was defined as ≥2 HIV care visits/labs ≥90 days apart in the first year of ART. Cox models assessed the association between early retention in care, sex, and sexual mode of HIV acquisition [i.e., women, heterosexual men and men who have sex with men (MSM)], and mortality. Associations were estimated separately by site and pooled. Among 11,721 included PLWH (median follow-up, 4.3 years; interquartile range, 2.0–7.6), 647 died (rate = 10.9/1000 person-years) and 1985 were lost to follow-up (rate = 33.6/1000 person-years). After adjustment for confounders, early retention in care was associated with lower mortality during subsequent years (pooled hazard ratio = 0.47; 95% confidence interval = 0.39–0.57). MSM had lower and heterosexual men had comparable mortality risk to women; risks were similar when adjusting for early retention in care. Additionally, no evidence of an interaction between early retention in care and sex and sexual mode of HIV acquisition on mortality was observed (p > 0.05). Early retention in care substantially reduced mortality but does not mediate or modify the association between sex and sexual mode of HIV acquisition and mortality in our population. en_US
dc.language.iso eng
dc.publisher Mary Ann Liebert
dc.relation.ispartofseries AIDS Patient Care and STDs
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Retention in care en_US
dc.subject Mortality en_US
dc.subject Sex Disparities en_US
dc.subject HIV en_US
dc.subject Americas en_US
dc.title Early Retention in Care Neither Mediates Nor Modifies the Effect of Sex and Sexual Mode of HIV Acquisition on HIV Survival in the Americas en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1089/apc.2018.0028
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 1557-7449


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