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Treatment adherence and health outcomes in MSM with HIV/AIDS: patients enrolled in "one-stop" and standard care clinics in Wuhan China.

  • Author(s): Zhou, Wang
  • Zhao, Min
  • Wang, Xia
  • Schilling, Robert F
  • Zhou, Sheng
  • Qiu, Hong-Yan
  • Xie, Nian-Hua
  • Liu, Man-Qing
  • Dong, Han-Sheng
  • Yao, Zhong-Zhao
  • Cai, Thomas
  • et al.
Abstract

BACKGROUND: Conducted in Wuhan China, this study examined follow-up and health markers in HIV patients receiving care in two treatment settings. Participants, all men who have sex with men, were followed for 18-24 months. METHOD: Patients in a "one-stop" service (ACC; N = 89) vs those in standard care clinics (CDC; N = 243) were compared on HIV treatment and retention in care outcomes. RESULTS: Among patients with CD4 cell count ≦350 cells/µL, the proportion receiving cART did not differ across clinic groups. The ACC was favored across five other indicators: proportion receiving tests for CD4 cell count at the six-month interval (98.2% vs. 79.4%, 95% CI 13.3-24.3, p = 0.000), proportion with HIV suppression for patients receiving cART for 6 months (86.5% vs. 57.1%, 95% CI 14.1-44.7, p = 0.000), proportion with CD4 cell recovery for patients receiving cART for 12 months (55.8% vs. 22.2%, 95% CI 18.5-48.6, p = 0.000), median time from HIV confirmation to first test for CD4 cell count (7 days, 95% CI 4-8 vs. 10 days, 95% CI 9-12, log-rank p = 0.000) and median time from first CD4 cell count ≦350 cells/µL to cART initiation (26 days, 95% CI 16-37 vs. 41.5 days, 95% CI 35-46, log-rank p = 0.031). Clinic groups did not differ on any biomedical indicator at baseline, and no baseline biomedical or demographic variables remained significant in the multivariate analysis. Nonetheless, post-hoc analyses suggest the possibility of self-selection bias. CONCLUSIONS: Study findings lend preliminary support to a one-stop patient-centered care model that may be useful across various HIV care settings.

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