期刊
CLINICAL INFECTIOUS DISEASES
卷 52, 期 -, 页码 S238-S246出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciq048
关键词
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资金
- National Institute of Mental Health [K23MH082641]
- University of Alabama at Birmingham Center for AIDS Research [P30AI27767]
- CFAR- Network of Integrated Clinical Systems [R24AI067039-1]
- Bristol-Myers Squibb, Positive Charge Initiative
- Bristol-Myers Squibb, Positive Charge
- Bristol-Myers Squibb
- Gilead Sciences
- Pfizer
- Tibotec Therapeutics
- Achillion Pharmaceuticals
- Avexa
- Boehringer Ingelheim
- Gilead
- GlaxoSmithKline
- Merck
- Monogram Biosciences
- Panacos
- Progenics
- Roche
- Serono
- Tanox
- Tibotec
- Trimeris
- Vertex
Grounded in a socio-ecological framework, we describe salient health care system and policy factors that influence engagement in human immunodeficiency virus (HIV) clinical care. The discussion emphasizes successful programs and models of service delivery and highlights the limitations of current, fragmented health care system components in supporting effective, efficient, and sustained patient engagement across a continuum of care. A fundamental need exists for improved synergies between funding and service agencies that provide HIV testing, prevention, treatment, and supportive services. We propose a feedback loop whereby actionable, patient-level surveillance of HIV testing and engagement in care activities inform educational outreach and resource allocation to support integrated testing and linkage to care plus service delivery. Ongoing surveillance of programmatic performance in achieving defined benchmarks for linkage of patients who have newly diagnosed HIV infection and retention of those patients in care is imperative to iteratively inform further educational efforts, resource allocation, and refinement of service delivery.
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