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American Journal of Epidemiology Vol. 154, No. 6 : 563-573
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health


PRACTICE OF EPIDEMIOLOGY

Retention of Women Enrolled in a Prospective Study of Human Immunodeficiency Virus Infection: Impact of Race, Unstable Housing, and Use of Human Immunodeficiency Virus Therapy

Nancy A. Hessol1, Michael Schneider2, Ruth M. Greenblatt1,3, Melanie Bacon4, Yvonne Barranday5, Susan Holman6, Esther Robison7, Carolyn Williams8, Mardge Cohen9 and Kathleen Weber9for the Women's Interagency Human Immunodeficiency Virus Collaborative Study Group

1 Department of Medicine, University of California, San Francisco, CA.
2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
3 Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
4 Georgetown University Medical Center, Washington, DC.
5 University of Southern California Medical Center, Los Angeles, CA.
6 Health Science Center, State University of New York, Brooklyn, NY.
7 Montefiore Medical Center, Bronx, NY.
8 Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
9 The Core Center, Cook County Hospital, Chicago, IL.

Even though women and people of color represent an increasing proportion of US acquired immunodeficiency syndrome (AIDS) cases, few research studies include adequate representation of these populations. Here the authors describe recruitment and retention of a diverse group of human immunodeficiency virus (HIV)-infected and at risk HIV-uninfected women in a prospective study operating in six sites across the United States. Methods used to minimize loss to follow-up in this cohort are also described. For the first 10 study visits that occurred during a 5-year period between 1994 and 1999, the retention rate of participants was approximately 82%. In adjusted Cox analysis, factors associated with retention among all women were older age, African-American race, stable housing, HIV-infected serostatus, past experience in studies of HIV/AIDS, and site of enrollment. In an adjusted Cox analysis of HIV-infected women, African-American race, past experience in studies of HIV/AIDS, site of enrollment, and reported use of combination or highly active antiretroviral HIV therapy at the last visit were significantly associated with retention. In adjusted Cox analysis of HIV-uninfected study participants, only the site of enrollment was significantly associated with study retention. These results show that women with and at risk for HIV infection, especially African-American women, can be successfully recruited and retained in prospective studies.

cohort studies; HIV; prospective studies; women

Abbreviations: AIDS, acquired immunodeficiency syndrome; HIV, human immunodeficiency virus; WIHS, Women's Interagency HIV Study


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