Patient Retention in HIV Medical Care in a Primary Care Practice in Australia

NCT02167100 | Completed

• 2 other identifiers: Retention in Care AuditHIV Retention in Care
• Study Type: observational
• Target: 1,537
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine linkage and retention in care in patients with HIV infection and reasons for loss to follow up Care in a High HIV-caseload Inner City Primary Care Practice in Sydney, Australia. The investigators hypothesise that patients attending HHMP will have higher rates of linkage and retention in care than the US HIV-infected population, and equivalent to Australian modelling.

Conditions

HIV

Keywords

HIV; Highly Active Antiretroviral Therapy; Patient Care; Patient Care Management; Lost to Follow-Up

Outcome Measures

Primary Outcomes (1)

• The primary outcome measures are the rates of current linkage and retention in care for HIV-infected adults at Holdsworth House Medical Practice (HHMP) over a 5-year period

  Up to 5 years

Secondary Outcomes (1)

• A secondary outcome measure is to determine the factors associated with loss to follow up (LTFU) in the study population over a 5-year period

  Up to 5 years

Other Outcomes (6)

• Determining the reasons for LTFU - death, move to another practice, move interstate or overseas, other reason, unknown

  Up to 5 years

• The proportion of patients on antiretroviral therapy vs. not on therapy

  Up to 5 years

• The proportion of patients with undetectable viral load i.e. most recent plasma HIV RNA <50 copies/mL

  Up to 5 years

Study Arms (2)

Retained in Care

Each patient who had at least 2 practice visits separated by ≥90 days in a year involving HIV laboratory monitoring until 31st of March 2014.

Lost to follow-up (LTFU)

Each patient who had at 2 practice visits separated by ≥90 days in a year involving HIV laboratory monitoring but did not maintain regular attendance at HHMP until 31st March, 2014.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

HIV-infected patients attending HHMP from 1st January 2009 to 31st March 2014 inclusive, who had at least 2 practice visits separated by ≥90 days in a year involving HIV laboratory monitoring whilst attending HHMP.

You may qualify if:

• Documented HIV-1 infection
• Attendance during the study period for at least 2 visits \>3 months and \<12 months apart with measured laboratory virological or immunological markers (either on-site or at a co-management site)

You may not qualify if:

• Attendance by patient with HIV infection who does not have laboratory markers of HIV viral load or CD4 count measured
• Initial visit after 1st January 2014

Sponsors & Collaborators

• Holdsworth House Medical Practice: lead
• Gilead Sciences: collaborator

Study Sites (1)

Holdsworth House Medical Practice

Darlinghurst, New South Wales, 2010, Australia

Location

Related Publications (7)

• Hall HI, Halverson J, Wilson DP, Suligoi B, Diez M, Le Vu S, Tang T, McDonald A, Camoni L, Semaille C, Archibald C. Late diagnosis and entry to care after diagnosis of human immunodeficiency virus infection: a country comparison. PLoS One. 2013 Nov 5;8(11):e77763. doi: 10.1371/journal.pone.0077763. eCollection 2013.

  PMID: 24223724 BACKGROUND

• Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011 Mar 15;52(6):793-800. doi: 10.1093/cid/ciq243.

  PMID: 21367734 BACKGROUND

• Centers for Disease Control and Prevention (CDC). Vital signs: HIV prevention through care and treatment--United States. MMWR Morb Mortal Wkly Rep. 2011 Dec 2;60(47):1618-23.

  PMID: 22129997 BACKGROUND

• Mugavero MJ, Lin HY, Willig JH, Westfall AO, Ulett KB, Routman JS, Abroms S, Raper JL, Saag MS, Allison JJ. Missed visits and mortality among patients establishing initial outpatient HIV treatment. Clin Infect Dis. 2009 Jan 15;48(2):248-56. doi: 10.1086/595705.

  PMID: 19072715 BACKGROUND

• Das M, Chu PL, Santos GM, Scheer S, Vittinghoff E, McFarland W, Colfax GN. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS One. 2010 Jun 10;5(6):e11068. doi: 10.1371/journal.pone.0011068.

  PMID: 20548786 BACKGROUND

• Fang CT, Hsu HM, Twu SJ, Chen MY, Chang YY, Hwang JS, Wang JD, Chuang CY; Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan. J Infect Dis. 2004 Sep 1;190(5):879-85. doi: 10.1086/422601. Epub 2004 Jul 22.

  PMID: 15295691 BACKGROUND

• Giordano TP, Visnegarwala F, White AC Jr, Troisi CL, Frankowski RF, Hartman CM, Grimes RM. Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure. AIDS Care. 2005 Aug;17(6):773-83. doi: 10.1080/09540120412331336652.

  PMID: 16036264 BACKGROUND

Study Officials

• Mark T Bloch, MBBS

  Holdsworth House Medical Practice

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director

Study Record Dates

• First Submitted: June 5, 2014
• First Posted: June 18, 2014
• Study Start: June 1, 2014
• Primary Completion: September 1, 2015
• Study Completion: September 1, 2015
• Last Updated: September 21, 2015

Record last verified: 2015-09

Locations

AU (1)