Missed clinic visits in youth living with HIV in Alabama: A Cohort Study

Introduction: Missed visits are associated with poorer treatment and health outcomes among people living with HIV (PLWH). Studies have found that demographic factors and viral suppression are associated with missed visits. However, gaps in knowledge remain related to how missed visits may affect youth living with HIV (YLWH), a vulnerable subpopulation. Methods: In this exploratory study, we examined data from an Alabama academic Ryan White funded HIV clinic to assess correlations of missed visits among young clients (ages 16 to 24). Ninety-six YLWH seen between March 1, 2020 to August 31, 2021 were included. Chi-square test was used to establish the association between missed visits and treatment outcomes. Unadjusted binary logistic regression analysis was performed to estimate the factors associated with missed visits. Results: Fifty youth clients (46.88%) had at least one missed visit. Missed visits were associated with one negative treatment outcome: YLWH with missed visits had more viral load rebound (p=0.04). We also found that identifying as a cisgender male (OR=3.35, 95% CI: 1.10-10.20) and being virally suppressed at the index visit (OR=0.41, 95% CI: 0.18-0.94) were associated with missed visits among YLWH. Conclusion: Missed visits is an important indicator of retention in HIV care for youth. More research is needed to elucidate risk factors associated with missed visits in YLWH in order to better inform intervention development and improve retention in care for youth.