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首页> 外文期刊>AIDS Research and Human Retroviruses >Trends in HIV Continuum of Care Outcomes over Ten Years of Follow-Up at a Large HIV Primary Medical Home in the Southeastern United States
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Trends in HIV Continuum of Care Outcomes over Ten Years of Follow-Up at a Large HIV Primary Medical Home in the Southeastern United States

机译：在美国东南部的大型艾滋病毒原代医疗房前，艾滋病毒连续艾滋病毒连续性的趋势

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Longitudinal studies of retention in care (RIC) and viral suppression (VS) in the southeastern United States (US), a region disproportionately affected by HIV infection, are lacking. HIV-infected adults with 1 medical visit at the Vanderbilt Comprehensive Care Clinic (Nashville, Tennessee) from 2004 to 2013 were included. RIC was 2 (a) laboratory dates [CD4+ counts or HIV-1 viral loads (VLs)] or (b) provider encounters and/or laboratory dates in the year of interest, 90 days apart. VS was a VL of <200 copies/ml at last measurement in the year of interest. Modified Poisson regression estimated relative risk (RR) of RIC and VS, adjusting for age, race, sex, HIV transmission risk, and socioeconomic status (SES). Among 4,641 persons, 76.8% achieved RIC and 70.2% achieved VS. RIC and VS increased from 2004 to 2013 (p<.001 each). For lack of RIC, younger patients (RR=1.2 and RR=1.1, 18-24 and 25-34 vs. 35-44 year-olds, respectively), Blacks (RR=1.3 vs. Whites), and injection drug users (IDUs) (RR=1.2 vs. heterosexual contact [Hetero]) fared worse (p<.05 each); those with male-to-male sexual contact fared better (RR=0.8 vs. Hetero, p<.05). For lack of VS, younger patients (RR=1.3 and RR=1.2, 18-24 and 25-34 vs. 35-44 year olds, respectively), Blacks (RR 1.3 vs. Whites), Females (RR=1.1 vs. Males), IDUs (RR 1.3 vs. Hetero), and those with low SES (RR=1.1 vs. not low SES) fared worse (p<.05, each). RIC and VS increased over time, suggesting that efforts to improve outcomes have been effective. However, disparities persist and resources should focus on groups most at risk.
机译：缺乏对护理（RIC）和病毒抑制（VS）在美国（美国）的病毒抑制（VS）的纵向研究，缺乏艾滋病毒感染不成比例地影响的区域。包括艾滋病毒感染的成年人，在2004年至2013年的Vanderbilt综合保健诊所（Nashville，田纳西州）的艾滋病毒感染的成年人。 Ric是2（a）实验室日期[CD4 +计数或HIV-1病毒负载（VLS）]或（B）提供者在兴趣年份遇到和/或实验室日期，分开90天。 vs是在兴趣年度上次测量时的<200份/ ml的VL。修改的泊松回归估计RIC和VS的相对风险（RR），调整年龄，种族，性别，艾滋病毒传播风险和社会经济地位（SES）。在4,641人中，76.8％取得了富裕，70.2％实现了与RIC和VS从2004年增加到2013年（每次p <.001）。由于缺乏RIC，小患者（RR = 1.2和RR = 1.1,18-24和25-34，分别为35-44岁），黑人（RR = 1.3 VS. WITE）和注射药物（ IDUS）（RR = 1.2与异性致命触点[异质]）更差（每次P <.05）;那些具有男性到男性的性接触的人更好（RR = 0.8 Vs. hetero，p <.05）。对于缺乏VS，年轻的患者（RR = 1.3和RR = 1.2,18-24和25-34，分别为35-44岁），黑人（RR 1.3与Whites），女性（RR = 1.1与雄性），IDU（RR 1.3 Vs. hotoro），具有低SES（RR = 1.1与低SES）的人更差（每次p <.05）。随着时间的推移，ric和vs增加，这表明改善结果的努力已经有效。然而，差异持续和资源应关注大多数风险的群体。

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