Factors associated with lapses in care among people living with HIV in South Carolina

Utilizing statewide electronic health records (EHR) data, this study aims to assess the factors determining the occurrence of lapses in HIV care among people with HIV (PWH) in South Carolina (SC). All adult (≥ 18 years old) PWH who were diagnosed with HIV between 2006 and 2018 with at least two HIV care encounters and at least 1-year follow-up record were included in the analysis. The outcome, a lapse in care, was defined as a repeated measure of HIV care encounter that occurs over a year following the previous visit. Generalized Estimation Equation models were employed. The study cohort had 8,856 PWH, of which 3,888 (43.9%) had a lapse in HIV care, and 1,405 (36.14%) PWH had multiple lapses. Background characteristics, such as longer duration of HIV diagnosis, being male, and being infected with HIV through injecting drug use or men who have sex with men were associated with a higher risk of a lapse in care. A variety of comorbidities, such as cardiovascular disease, liver disease, and renal disease, were associated with lower odds of a lapse in HIV care.