486. Patient-Nominated Treatment Supporters And Retention In Care Among People Living With HIV/AIDS In Peru
Session: Poster Abstract Session: HIV Care Continuum
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDSA2016_poster_No486.pdf (432.3 kB)
  • Background: Upon enrollment into the Peruvian National HIV Program, people living with HIV (PLWH) nominate treatment supporters (TS) among their close contacts during social work (SW) evaluations. This strategy to potentially facilitate retention in care has received insufficient attention.

    Methods: This retrospective cohort study included adult PLWH enrolled between 2011-2014 in a government hospital in northern Lima who were evaluated by SW. We studied the association between baseline PLWH characteristics and having TS. We also studied the association between having TS and retention in care one and two years after enrollment, defined as completing ≥2 medical provider visits, >90 days apart within a 12-month period. We assessed the association between baseline characteristics, having TS, and retention in care using generalized linear models.

    Results: Among 1384 PLWH, 23.6% were women, 44.1% were men who have sex with men (MSM) and 32.2% were heterosexual men; the median age was 32.2 (IQR=26.2-41.2). TS were identified by 1238 (89.5%) PLWH, and comprised family members (64.4%), partners (20.8%), and friends (14.8%). In the adjusted model, non-disclosure of HIV status to relatives (PR: 5.80, 95% CI: 4.12-8.14), being unmarried (PR: 1.93, 95% CI: 1.18-3.16), and age >29 years (PR: 1.64, 95% CI: 1.13-2.37) were associated with not having TS, while sex, being MSM and WHO Clinical Stage were not. Retention in care was 74.7% (1034/1384) and 34.6% (342/988) after one and two years respectively. Although not statistically significant, PLWH with TS had higher retention in care after one year (75.4% vs 68.5%, p=0.068). PLWH with TS had significantly higher retention in care after two years (36.2% vs 20.8%, p=0.002). After adjusting for ART initiation, baseline CD4 count, and baseline WHO Clinical Stage, having TS was associated with retention after two years (RR: 1.67, 95% CI: 1.13-2.45) but not with retention after one year (RR: 1.06, 95% CI: 0.96-1.17).

    Conclusion: Most PLWH nominated TS, primarily among their family members. Non-disclosure of HIV status, being unmarried and being older might limit the identification of supporters. Having TS appears beneficial for long-term retention in care; however additional interventions to improve retention are needed.

    Mateo Prochazka, MD1, Larissa Otero, MD MPH1, Kelika Konda, PhD2, Elsa Gonzalez, MD, MPH1 and Eduardo Gotuzzo, MD, FIDSA FACP3,4, (1)Instituto De Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, (2)Department of Medicine, Division of Infectious Diseases and Center for World Health, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, WA, (3)Department of Infectious, Tropical and Dermatological Diseases, Hospital Cayetano Heredia, Lima, Peru, (4)Instituto De Medicina Tropical "Alexander Von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru

    Disclosures:

    M. Prochazka, None

    L. Otero, None

    K. Konda, None

    E. Gonzalez, None

    E. Gotuzzo, None

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