Retention in care in aging adults with a dual diagnosis of HIV infection and type 2 diabetes mellitus: a longitudinal retrospective cross-sectional study.

BACKGROUND: This study aimed to investigate the measures of retention in care (RIC) in persons living with HIV (PLWH) and type 2 diabetes mellitus (T2DM) by age group (younger vs. older adults). METHODS: This was a longitudinal retrospective cross-sectional study that used secondary data from the Center for AIDS Research Network of Integrated Clinical Systems (CNICS). We examined RIC in 798 adult PLWH + T2DM who visited a CNICS clinic at least once in 2015. Six measures of RIC were examined: missed visits [measured as a continuous variable (total number of missed visits) and dichotomous variable (0 = never missed, 1 = missed)], visit adherence, 6-month visit gap, 4-month visit constancy, and the Health and Resources Services Administration HIV/AIDS Bureau's RIC measure. We calculated Spearman correlation coefficients and conducted logistic regression and multi-group path analysis. RESULTS: Most RIC measures were significantly correlated (p < 0.05) with one another; only 4-month visit constancy was not correlated with other measures. Except for the number of missed visits in older adult PLWH + T2DM, we found no significant relationships between RIC measures and CD4 cell count using logistic regression. However, multi-group path analysis demonstrated significant positive relationships between most RIC measures and CD4 cell count in both age groups. In younger adults living with HIV (YALWH) + T2DM, HbA1c level, but not CD4 count, was significantly associated with most RIC measures. CONCLUSIONS: RIC is related to disease control (CD4 cell count and HbA1c level) in PLWH + T2DM and notably, HbA1c level was only significantly affected in YALWH + T2DM. A future study is needed to find more accurate reasons for the fact that only HbA1c level had significant relationships in YALWH + T2DM. The findings from this study provide guidance in measuring RIC in PLWH who have comorbidities.

Occupational Health Injuries by Job Characteristics and Working Environment among Street Cleaners in South Korea.

In 2018, 1822 incidents relating to death or injury occurred among street cleaners in South Korea. However, South Korea currently lacks comprehensive studies on related injuries based on street cleaners' job characteristics and environments in the country. This study analyzed injuries according to the job characteristics and environment through a survey of 150 Korean street cleaners working in the Seoul and Gyeonggi-do areas. This study assessed three category measures-demographic, job characteristics, and environments-to determine the effects of injuries. The demographic measures consisted of age, gender, and education level. Job characteristic variables consisted of length of time on the job, job contract, monthly income, working hours per day, working start time, overtime per month, and days off per month. For job environments, this survey included job duty, classification, main tasks, work intensity, and safety equipment. The data were analyzed according to descriptive statistics, injury ratio, and Probit regression analysis. The results of the analysis demonstrated that the participants with the highest risk of injury were mostly males with less than a middle school education. Assessment of the job characteristics showed that the most prevalent length of working experience was less than 5 years, with most engaging in contract/day work. A share of 36.67% of the participants reported injuries. The most prevalent reason for injury was overwork (32.73%), and the most frequent injury area was the lower back (49.09%). In summary, injuries among street cleaners were associated with education level, job experience, days off from work, and work intensity. As such, street cleaners should receive more education to decrease the risk of injuries, regardless of the number of employees or their contract status.