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Multiple social and health factors associated with irregular attendance at London HIV clinics
Roger Pebody, 2016-04-22 10:20:00
People who miss appointments for HIV care are more likely to
have money problems, childcare responsibilities and a history of depression
according to a recent UK study.
While poor attendance was more common in women, other demographic factors including ethnicity and sexual orientation were not associated with poor attendance. And there was little evidence that differences
in the way services are provided affected engagement with care – probably
reflecting the generally high quality of care provided at specialist HIV
clinics in the UK.
Fiona Burns of University College London presented the data
to the Public Health England HIV Reporters’ Meeting last week. The study was
also presented in a poster at the recent Conference on Retroviruses and
Opportunistic Infections (CROI 2016).
A total of 983 patients attending seven London HIV clinics
completed a survey on social factors and their experience of care. The data
were linked to clinic records of medical issues and of attendance. Because the
study was set up to better understand problems with engagement with care, the
researchers attempted to recruit a greater proportion of patients with poor
attendance than they would normally find.
Five hundred and fifty respondents were regular attenders (had attended all
appointments in the past year), 269 were irregular attenders (had missed at
least one appointment) and 164 were classified as non-attenders (had recently
disengaged with care for at least a year).
Otherwise the sample broadly reflects the patient population
in London – six in ten were gay men, just over half were white, over a quarter
were women, over a quarter were black African, and six in ten were born outside
the UK. Whereas a quarter had been diagnosed in the past five years, half were
diagnosed more than ten years ago.
There were statistically significant associations between
poor attendance and the following demographic factors:
- Female sex
- Younger age
- Less education
- More time since diagnosis of HIV
But people born outside the UK, people of different
ethnicities, and people of different sexual orientations were no more or less
likely to have poor attendance than other people.