403. Non-HIV Care Utilization Among Young Adults And Its Association with Their Engagement And Adherence to HIV Care
Session: Poster Abstract Session: HIV Engagement in Care and the Care Cascade
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDSA poster pdf.pdf (648.3 kB)
  • Background: Despite major advances in treatment options, only a minority of individuals with HIV have achieved viral suppression. The young adult (YA) population struggles with HIV management and has higher rates of non-adherence compared to older patients. Additionally, YA have the highest rates of new cases of HIV. The need for a better understanding of factors associated with inadequate viral load suppression is imperative.

    Methods: Retrospective review was performed on 137 patients 18-25 y/o and seen for HIV care at an urban academic county hospital during the first six months of 2012. Demographics, utilization, comorbidities, and labs from 2012-2014 was extracted from the EMR. We classified patients as engaged if they had an office visit in each half of the calendar year and suppressed if their viral load was < 400 copies/ml in each half of the year.

    Results: Engagement in care correlated with more ED visits, more hospitalizations (2014), and an identified mood disorder. Viral suppression correlated with mood disorder. Those engaged in care in 2012 were more likely to stay engaged in care and maintain viral suppression. Initial viral suppression correlated with future suppression. Demographic factors were not associated with outcomes of interest.

     

                     

    2012

    2013

    2014

    Engaged in Care

     p-value

     p-value

     p-value

    ED Visits

    .007

    .033

    .051

    Inpatient Encounters

    .143

    .092

    .030

    Mood disorders

    .003

    .007

    .000

    Virally Suppressed

     

     

     

    ED Visits

    .198

    .247

    .172

    Inpatient Encounters

    .072

    .145

    .199

    Mood disorders

    .012

    .004

    .000

    Conclusion: Patients seen regularly were more likely to have an identified mood disorder, visit the ED, and be admitted. This suggests that some HIV+ YA utilize the healthcare system as a whole more frequently. Future studies could target incentivizing clinic visits and its effect on viral suppression. This data also identifies the ED as another significant opportunity for intervention and education of YA with HIV.

    Leila Hojat, MD, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, Steven Lewis, MS, MBA, MetroHealth Medical Center, Cleveland, OH and Ann Avery, MD, Medicine, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH

    Disclosures:

    L. Hojat, None

    S. Lewis, None

    A. Avery, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.