Abstract Background Understanding factors influencing retention in care (RIC) and viral load improvement (VLI) in people with HIV (PWH) who are out of care and hospitalized will assist in intervention development for this vulnerable population. Methods The study was a post hoc analysis of prospectively collected data. Hospitalized participants were enrolled if they were newly diagnosed with HIV during the hospitalization or out of HIV care. Participants completed surveys at baseline and 6 months postenrollment and laboratory studies of viral load (VL). Outcomes were RIC (2 completed visits, 1 within 30 days of discharge) and VLI (VL <400 or at least a 1-log10 decrease) 6 months after discharge. Univariate and multivariate regression analyses were conducted examining the contributions of predisposing, enabling, and need factors to outcomes. Results The study cohort included 417 participants enrolled between 2010 and 2013. The population was 73% male, 67% non-Hispanic black, 19% Hispanic, and 70% uninsured. Sixty-five percent had a baseline CD4 <200 cells/mm3, 79% had a VL >400 copies/mL or missing, and the population was generally poor with low educational attainment. After discharge from the hospital, 60% did not meet the definition for RIC, and 49% did not have VLI. Modifiable factors associated with the outcomes include drug use (including marijuana alone and other drugs), life instability (eg, housing, employment, and life chaos), and using avoidance coping strategies in coping with HIV. Conclusions Hospitalized out-of-care PWH in the United States are at high risk of poor re-engagement in care after discharge. Interventions for this population should focus on improving socioeconomic stability and coping with HIV and reducing drug use.

中文翻译：

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住院的非护理 HIV 感染者出院后的护理保留和病毒载量改善：随机对照试验的事后分析


摘要 背景 了解影响脱离护理和住院的艾滋病毒感染者 (PWH) 保留护理 (RIC) 和病毒载量改善 (VLI) 的因素将有助于针对这一弱势群体制定干预措施。方法 该研究是对前瞻性收集的数据进行事后分析。如果住院参与者在住院期间或离开艾滋病毒护理期间新诊断出感染艾滋病毒，则将其纳入研究。参与者完成了基线调查和入组后 6 个月的调查以及病毒载量 (VL) 的实验室研究。结果为 RIC（2 次完成就诊，1 次在出院 30 天内）和 VLI（VL <400 id=88>400 拷贝/mL 或缺失，人群普遍贫困，受教育程度较低。出院后，60 % 不符合 RIC 的定义，49% 没有与结果相关的可改变因素，包括吸毒（包括单独吸食大麻和其他毒品）、生活不稳定（例如住房、就业和生活混乱）以及结论 美国住院的非护理艾滋病患者出院后重新参与护理的风险很高，针对该人群的干预措施应侧重于改善社会经济稳定性和应对艾滋病毒和艾滋病毒。减少药物使用。