Friday, April 1, 2016

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic

The HIV care continuum has received considerable attention in recent years, however few care continua focus on the population of patients who are diagnosed during an inpatient hospital admission. We aimed to describe the HIV care continuum for patients newly diagnosed during hospitalization through 24-month follow-up. 

A retrospective chart review of HIV patients diagnosed at Grady Memorial Hospital from 2011 - 2012 was performed and records were matched to Georgia Department of Public Health HIV/AIDS surveillance data. Descriptive statistics and statistical tests of independence were utilized. 

Ninety-four new diagnoses were confirmed during the two-year study period. Median age was 43 years old (IQR 30 - 51), 77% were male, 72% were non-Hispanic Black, 31% were men who have sex with men (MSM) and 77% were uninsured. Median CD4 count at diagnosis was 134 cells/┬ÁL (IQR 30 - 307). Eighty-four percent received their diagnosis prior to hospital discharge, 68% linked to care by 90 days, 73% were retained for 12 months, 48% were virologically suppressed by 12 months, 58% were retained for 24 continuous months and 38% achieved continuous VS during the initial 24 months after diagnosis. 

Late diagnosis is a persistent problem in hospitalized patients. Despite relative success with linkage to care and 12-month retention in care, a minority of patients maintained retention and VS for 24 continuous months.

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  • 1Emory University, Medicine , 49 Jesse Hill Jr Drive , Division of Infectious Diseases , Atlanta, Georgia, United States , 30303 ; jcolasa@emory.edu.
  • 2Atlanta, United States ; neela.goswami@emory.edu.
  • 3Los Angeles, United States ; jacob.khoubian@gmail.com.
  • 4Atlanta, United States ; alpennisi@dhr.state.ga.us.
  • 5Atlanta, United States ; cmroot@emory.edu.
  • 6Atlanta, United States ; dziemer@GMH.EDU.
  • 7Emory University, Infectious Disease, Atlanta, Georgia, United States ; wsarmst@emory.edu.
  • 8Emory University, Hubert Department of Global Health , 1518 Clifton Rd. NE , CNR Building , Room 7011 , Atlanta, Georgia, United States , 30322 ; cdelrio@emory.edu. 
  •  2016 Mar 22.



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