by Mike Andrew - SGN Staff Writer

More than one in four HIV/AIDS patients in the United States do not get consistent medical care for their disease, a new study published in the journal AIDS reveals.

The study is one of the first to estimate care retention in the U.S.

According to the report's lead author, retention is key to keeping HIV-positive patients healthy and to prevention of new infections.

'Helping patients with HIV stay in care is a key way to reduce their chances of getting sick from their disease and prevent the spread of HIV in the community,' stated Dr. Baligh Yehia of the University of Pennsylvania.

Researchers studied 17,425 HIV-positive adults at 12 U.S. clinics. Only 42% of patients had 'no gap' in treatment - that is, no more than six months in between visits to a doctor.

However, 31% had at least one seven- to 12-month gap in care. Alarmingly, 28% of the HIV-positive patients - more than one in four - did not access medical care for over a year.

Women, white patients, older patients, men who had sex with men, and patients on Medicare - as opposed to those on private insurance - remained in care more consistently.

Access to care was also greater among patients with low CD4 counts, indicating a more advanced stage of HIV disease.

Researchers said they hoped their findings would help doctors improve care by revealing obstacles to adherence and indicating which patients might need help to follow through in seeing their doctors.

'Clinicians need to know what barriers to screen for, so our findings help to better define groups of patients who may require extra help to stay on track,' said the study's co-author, Dr. Kelly Gebo of the Johns Hopkins University School of Medicine.

Housing, transportation, and financial problems, substance abuse, and mental illness all hinder care retention, the study said, and patients who do not show symptoms of HIV/AIDS may believe they are not sick enough to need regular visits to a doctor.

'It's possible that as time goes by, some patients may become more regular users of care, while others may become complacent and skip appointments,' Yehia said.

'We need to better pinpoint times when certain patients may be less likely to remain in treatment, and find ways to ensure their continued care.'

This new study follows a recent CDC report that only 28% of HIV/AIDS patients show a suppressed viral load, indicating they have the disease under control. One obvious explanation for the CDC finding is that controlling HIV requires regular medical care.

Of those who know they are HIV-positive, the CDC said, only half receive ongoing medical care. But as many as one in five HIV-positive individuals do not seek treatment because they are completely unaware they have the disease, according to the report.

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