An analysis by Kenneth Gadow, PhD and colleagues demonstrated the importance of taking selective attrition rates into account when estimating the incidence and prevalence of mental health problems in young people perinatally infected with HIV. Analyzing attrition data from a large study conducted by the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) network, they found that young people with a self-assessed psychiatric condition were more likely to be lost to follow-up after two years than those without a psychiatric condition. Among youth perinatally infected with HIV, however, the odds of youth with psychiatric conditions being lost to follow up were three times larger.
The data for the study came from the IMPAACT network’s P1055 study, a 2-year multi-site study designed to estimate the incidence and prevalence of mental health problems among perinatally infected young people. Initial analyses of the data did not show a measurable difference between the rates of psychiatric problems among perinatally infected youth and a demographically matched comparison group.
While more than 80% of the 575 participants remained in the study through a 2-year follow-up, young people with psychiatric problems were more likely to be lost to follow-up than those without psychiatric problems (23% vs. 17%). Among the participants perinatally infected with HIV, 24% of those with psychiatric problems were lost to follow-up, while only 11% of those without psychiatric problems were lost to follow-up.
The authors concluded that these findings may lead to underestimates of prevalence of psychiatric conditions at later ages and may introduce bias into studies of the risk factors for psychiatric problems among people perinatally infected with HIV. They suggested that researchers adjust for selective attrition, especially in studies where dropout rates are high.
The article, titled "Participation and Retention of Youth With Perinatal HIV Infection in Mental Health Research Studies: The IMPAACT P1055 Psychiatric Comorbidity Study," was published in the Journal of Acquired Immune Deficiency Syndrome.