Drop-out of medical follow-up among people living with HIV in Tel-Aviv area.
Daniel ChemtobItzchak LevyShai KaufmanNechama AverickAgate KraussDan TurnerPublished in: AIDS care (2021)
Access to HIV anti-retroviral treatment (ART) has significantly improved survival and the quality of life of people living with HIV (PLHIV). However, effective therapy necessitates high adherence to ART. The aim of this study was to identify the extent to which PLHIV in Israel were not retained in therapy and their obstacles to accessing care. The Department of Tuberculosis and AIDS (DTA) and the two existing HIV clinics in the Tel-Aviv metropolitan area performed a retrospective study for all PLHIV who were consulted at these clinics during 2008-2011, but were absent in 2012. From that population, 25% were randomly chosen for qualitative interviews. This study included 278 PLHIV not retained in care (13.4% of registered patients), of whom 194 (69.8%) were male, and 58.3% were Israeli citizens. Total number of clinic visits was 1959 (mean: 7.05 visits per patient; range: 1-39; SD: ±7.2) and the total person-years of follow-up for 267 PLHIV was 1,044 (mean: 3.9 py; 0-23; SD: ±4.4). Identified risk groups were: Originating from Generalized Epidemic countries (43.5%, 82.6% were non-Israelis); Men having Sex with Men (22.6%); Injecting Drug Users (12.9%) and Others (28.9%). Among Israelis, major reasons for clinic nonattendance included distance to the clinics and perceived lack of time. The major impediment to seeking care among undocumented migrants was lack of medical insurance. The DTA acted swiftly to make HIV-related services accessible to undocumented migrants. Barriers described by Israeli participants were generally more individual in nature, and should be addressed at the clinic level.
Keyphrases
- antiretroviral therapy
- primary care
- healthcare
- hiv infected
- hiv positive
- human immunodeficiency virus
- hiv aids
- palliative care
- hiv testing
- affordable care act
- hepatitis c virus
- mental health
- quality improvement
- end stage renal disease
- physical activity
- mycobacterium tuberculosis
- ejection fraction
- depressive symptoms
- newly diagnosed
- chronic kidney disease
- systematic review
- pain management
- social support
- health insurance
- stem cells
- adipose tissue
- south africa
- case report
- long term care
- free survival
- drug induced