[Treatment of HIV marginalized patients: an approach to documenting medical and psychosocial appointments of patients with problematic drug use]. / Traitement du VIH auprès d'une clientèle marginalisée: approche de proximité pour favoriser l'observance des rendez-vous.

OBJECTIVE: To document compliance with medical and psychosocial appointments for HIV/AIDS treatment in a population of marginalized individuals with problematic drug use. METHOD: This is a retrospective study exploring appointment compliance for an HIV treatment based on an outreach intervention. Information regarding the medical and psychosocial appointments of 185 patients of the HIV-Drug Addiction outpatient unit, at the University of Montreal Hospital Centre (CHUM), has been collected for a one-year period (2006-2007). The compliance rate of appointments has been calculated according to the type of care provided: 1) conventional, provided only in the clinic at the "fixed" location, and 2) outreach-based, when the team at the fixed location is complemented by the intervention of a "mobile" team for the more unstable patients. RESULTS: Compliance rates for medical and psychosocial appointments in patients receiving care solely at the fixed location is 61.4%. For those whom care is received at the fixed location while complemented by the mobile team, the corresponding rate is 73.9%. This is an elevated compliance rate, higher than those generally reported for outreach-based programs. CONCLUSION: These results lend support to the success of programs integrating an outreach-based intervention for a vulnerable clientele. Indeed, appointment compliance in those who are more disorganized, for which the mobile team has intervened, has proven comparable and even superior to compliance with appointments when treatment is only received at the fixed location.