Clinical outcomes after the implementation of a patient-centered care program applied to newly admitted people with HIV in Mexico City: a retrospective cohort study.

BACKGROUND

Although antiretroviral therapy (ART) has improved life expectancy in people living with HIV (PWH), sustained HIV care remains a critical challenge. The Newly Admitted Patients Program (NAPP), a local Patient-Centered Care (PCC) intervention, was implemented for patients admitted via the HIV clinic. We aimed to evaluate clinical outcomes (loss to follow-up (LTFU), hospitalization, treatment discontinuation (TD), virologic failure, and mortality) among participants in NAPP versus non-participants (No-NAPP).

MATERIALS AND

METHODS

We conducted a retrospective cohort study at a single tertiary-care center, including PWH from January 2015 to December 2023. Participants were followed from enrollment in the HIV clinic to their last visit. Clinical, demographic, and laboratory variables were analyzed, and adjusted logistic regression was used to identify factors associated with clinical outcomes.

RESULTS

We included 758 participants: 387 (51.1%) in the NAPP group and 371 (48.9%) in No-NAPP. NAPP participants were younger (median age 32 vs. 37 years, p < 0.01), more often MSM (78% vs. 70.1%, p = 0.04), and education levels differed (p = 0.014), though university/postgraduate attainment was similar between groups (53.7% vs. 55.8%). At follow-up, the NAPP group had lower rates of LTFU (10.9% vs. 27.8%, p < 0.01), hospitalization (21.9% vs. 32.6% p < 0.01), and mortality (3.4% vs. 8.9%, p < 0.01). NAPP participation was independently associated with reduced risk of LTFU (OR = 0.32, 95% CI = 0.22-0.49), hospitalization (OR = 0.61, 95% CI 0.44-0.86), and death (OR = 0.42, 95% CI = 0.21-0.85).

CONCLUSIONS

Despite similar virological and immunological characteristics at baseline, those who participated in NAPP intervention experienced fewer unfavorable clinical outcomes, highlighting the importance of PCC programs in improving health outcomes for PWH.