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PLoS One. 2014 Dec 1;9(12):e113736. doi: 10.1371/journal.pone.0113736. eCollection 2014.

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

Author information

1
Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, China.
2
Wuhan Institute of Dermatovenereology, Wuhan, Hubei, China.
3
Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California, United States of America.
4
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
5
AIDS Care of China, Nanning, Guangxi, China.

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.

PMID:
25438039
PMCID:
PMC4249979
DOI:
10.1371/journal.pone.0113736
[Indexed for MEDLINE]
Free PMC Article

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