Predictive Factors for Loss to Postpartum Follow-up Among Low Income HIV-infected Women in Texas

Guidelines for HIV primary care include visits every 3 months (up to 6 months in those with stable HIV). During pregnancy, women with HIV commonly attend once weekly to once monthly visits; however, after delivery, many are lost to follow-up. Our goal was to assess the frequency of loss to primary care follow-up postpartum and to identify predictors of loss to care. A retrospective chart review of HIV-infected women in a Houston prenatal program was done. Optimal care was defined as one visit to HIV primary care providers (PCPs) every 6 months within the first year after delivery, and loss to follow-up as no visits within the first postpartum year. Multivariate logistic regression analysis was used to identify factors associated with loss to follow-up. Charts (n=213) were analyzed for follow-up with PCPs. The loss to follow-up rate was 39% in the first postpartum year. Associated factors were younger age, black race, late entry to prenatal care, and no plans for contraception. Predictors of loss to primary care after pregnancy can be used to identify specific subpopulations of pregnant women at highest risk for falling out of care.