Journal
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
Volume 70, Issue 3, Pages 262-268Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAI.0000000000000707
Keywords
cascade of care; HIV care continuum; engagement in care; retention in care; HIV surveillance
Categories
Funding
- National Institute of Mental Health [5K23MH090923]
- University of Washington Center for AIDS Research (CFAR), an NIH - NIAID [P30AI027757]
- University of Washington Center for AIDS Research (CFAR), an NIH - NCI
- University of Washington Center for AIDS Research (CFAR), an NIH - NIMH
- University of Washington Center for AIDS Research (CFAR), an NIH - NIDA
- University of Washington Center for AIDS Research (CFAR), an NIH - NICHD
- University of Washington Center for AIDS Research (CFAR), an NIH - NHLBI
- University of Washington Center for AIDS Research (CFAR), an NIH - NIA
- University of Washington Center for AIDS Research (CFAR), an NIH - NIGMS
- University of Washington Center for AIDS Research (CFAR), an NIH - NIDDK
- Health Resources and Services Administration
- Cempra pharmaceuticals
- Melinta Therapeutics
- Genentech
Ask authors/readers for more resources
Background:Improving patient retention in HIV care is crucial to improving the HIV care continuum. We instituted and evaluated a relinkage program that uses clinical data to identify potentially out-of-care patients, matches those data to public health surveillance, and employs a linkage specialist (LS) to coordinate care relinkage.Methods:The intervention began November 1, 2012, in the largest HIV clinic in Washington State. We evaluated program outcomes and compared patient outcomes in the year after initiation of the intervention to a historical control cohort of patients. Cox proportional hazard ratios were used to compare time to relinkage to care between cohorts, and regression models using generalized estimated equations were preformed to examine secondary outcomes of relinkage to care, engagement in care, and viral suppression.Results:A total of 753 patients were identified as out of care on November 1, 2012. Matching with surveillance data and initial LS investigations found that 596 (79%) of these patients had moved, transferred care, or were incarcerated. Of the 157 remaining patients, 40 (25%) relinked to care before LS contact, and the LS successfully contacted 38 (24%). A total of 116 (15%) patients in the intervention cohort relinked to care and 24 (20%) were contacted by the LS. Compared with the historical cohort, the time to relinkage was shorter among patients in the intervention cohort [adjusted hazard ratio = 1.7 (1.2-2.3)] and a greater proportion relinked (15% vs. 10%).Conclusions:This clinic-based surveillance-informed relinkage intervention showed statistically significant but modest effectiveness in returning out-of-care patients to HIV care compared with historical controls.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available