Jessica Ridgway, MD, MS, was recently awarded a research grant from the National Institute of Mental Health to better predict which patients living with HIV are most likely to discontinue HIV care. She will examine various populations using an analytic process called clinical phenotyping to determine who is at risk for loss to follow-up (LTFU). Better predicting LTFU will allow clinicians to keep more people living with HIV connected to care.

Jessica Ridgway
Jessica Ridgway, MD, MS

Ridgway is an associate professor of medicine at the University of Chicago and leads the Third Coast Center for AIDS Research (TC CFAR) Clinical Sciences Core. Anoop Mayampurath, PhD, an assistant professor of biostatistics and medical informatics at the University of Wisconsin, is the co-principal investigator on this project.

“Retention in care is important because people with HIV who are retained in care are more likely to be prescribed antiretroviral therapy, have an undetectable viral load, have improved health outcomes and decreased mortality, and are less likely to transmit HIV to others,” said Ridgway.

Retention in HIV care means that people with HIV are receiving regular medical care. For this study, Ridgway and her research team will use the 12-month gap measure of retention in care, so a person is retained in care if they attend HIV care appointments at least once every 12 months. LTFU means that a patient is not retained in care, and they are not receiving regular medical care for their HIV. This study will define LTFU as not having an HIV care appointment for over 12 months.

People with HIV are a heterogeneous population, and there likely exist sub-groups of patients (e.g., young Black men who have sex with men, cisgender women with childcare responsibilities, people who inject drugs and are not stably housed) that differ in the factors that are predictive of LTFU. Clinical phenotyping is an analytic method that can cluster patients within a heterogeneous population into different sub-groups based on their characteristics. For this study, Ridgway and her research team plan to model LTFU among different clinical phenotypes of people with HIV and validate the model compared to care team intuition regarding HIV patients’ risk for LTFU.

“It can be difficult to reengage people with HIV who are lost to follow-up back into care, and they can experience negative health outcomes during this time,” said Ridgway. “That is why we are trying to predict loss to follow-up so that we can prevent it from happening before it occurs.”

Ridgway has served on the Clinical Core for eight years and worked closely with the Developmental Core while providing many services to the TC CFAR’s members across all HIV research disciplines. In turn, the TC CFAR has supported Ridgway in creating new projects.

“This work is a continuation of a line of research that was kickstarted by my Developmental Core pilot award that I received in 2017,” said Ridgway. “The Clinical Core has also been instrumental in supporting the grant application and the project itself, through the HIV electronic datamart, which includes curated electronic medical record data for patients with HIV at the University of Chicago Medicine. The datamart is providing the information that will be analyzed in this project.”