RETENTION OF PEOPLE LIVING WITH HIV/AIDS IN CARE OVER FIVE YEARS OF FOLLOW-UP IN A SPECIALIZED PUBLIC SERVICE AND ASSOCIATED FACTORS

Retention in care is a challenge in the follow-up of people living with HIV/AIDS (PLHIV). This study evaluated linkage, retention, and viral suppression among newly diagnosed individuals and the factors associated with retention. Cohort study of PLHIV diagnosed and enrolled for care between 01/01/2019 and 12/31/2019, followed for five years. Retention was defined as absence of gaps longer than 180 days between visits for any HIV-related service. Simple and relative frequencies described sociodemographic characteristics, linkage, retention, and sustained viral suppression. Odds ratios estimated factors associated with retention (95% CI). 244 newly diagnosed PLHIV were enrolled. Median age was 29 years; 211 (86.5%) were cisgender men; 132 (54.1%) Black or mixed race; 197 (80.7%) MSM; 127 (52.1%) had university education. Median CD4 was 421 cells/mm³; median time to treatment initiation was 19 days. Twelve (4.1%) did not initiate care; two (0.8%) were untraceable; 232 (95.1%) linked to care. Of these, 12 (5.2%) transferred or died in the first six months. After five years, among 220 remaining patients, 167 (75.9%) remained active, 12 (5.5%) were lost to follow-up, 37 (16.8%) transferred, and 4 (1.8%) died. Sustained viral suppression (< 200 copies/mL) was achieved by 172 (78.2%). At least one episode of non-retention occurred in 61 (27.7%). Retention rates were 94.1% at year 1, 87.1% at year 2, 85.7% at year 3, 85.9% at year 4, and 83.8% at year 5. University education (OR = 2.4; 95% CI 1.3–4.5; P = 0.006) and absence of problematic alcohol use at diagnosis (OR = 6.4; 95% CI 2.1–19.4; P = 0.001) were associated with retention. Retention is a complex phenomenon requiring multiprofessional approaches. Low educational attainment, an indicator of social vulnerability, and problematic alcohol use were associated with non-retention, requiring targeted interventions.