Treatment Adherence and health outcomes in MSM with HIV/AIDS: Patients enrolled in "one-stop" and standard care clinics in Wuhan 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; N5243) were compared on HIV treatment and retention in care outcomes. Results: Among patients with CD4 cell count 蠆50 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 蠆50 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.