The National Strategy for Sexual Health and HIV aims to reduce the pool of undiagnosed HIV infection in the United Kingdom. (1) Potential benefits of earlier diagnosis include timely initiation of highly active antiretroviral therapy (HAART), prevention of complications of HIV, screening for STIs that are known to enhance HIV infectivity, (2) and psychological support. Patients may not realise these benefits if they are lost to follow up (LFU). Previous studies have found associations between frequent non-attendance (as distinct from LFU) and less severe illness, (3) drug addiction, (4) and patients' health beliefs. (5)
We studied the case notes of all surviving patients who had enrolled in our HIV clinic within a 15 month period but had not received medical care for 12 months or more. Patients were excluded if they had been transferred to other centres or if the case notes were unavailable. For each case, one control was matched for date of first attendance. Data including demographics, virological and immunological markers, antiretroviral therapy, and psychological and social factors were collected from the notes using a standardised proforma.
Ninety four cases were found. LFU patients were younger than controls (table 1), with a trend...