Predicting Retention in HIV Primary Care: Is There a Missed Visits Continuum Based on Patient Characteristics?

Missing 3 + scheduled HIV primary care visits over a 1-year period increases mortality risk for people living with HIV (PLWH). We used electronic health data from PLWH (≥ 18 years old) at a southeastern US HIV clinic in 2016 to examine differences across patient-level characteristics and number of missed visits (1–2 vs. 0, 3 + vs. 0, 3 + vs. 1–2). In multivariable multinomial logistic regression analyses, poverty, lack of Ryan White HIV/AIDS Program support services, being uninsured, not having a high school degree, and being younger were significantly associated with 1–2 or 3 + missed visits (vs. 0 missed). Only poverty remained predictive of missing 3 + versus 1–2 visits (RR = 2.70, 95% CI 1.49–4.88). Patients at risk for missing 3 + visits present similar characteristics to patients who miss 1–2 visits. Interventions aimed at poverty reduction and increased access to education, health insurance, and support services may improve retention and, therefore, decrease mortality risk.