Factors Influencing the Successful Implementation of HIV Linkage and Retention Interventions in Healthcare Agencies Across New York State
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As part of the System Linkages and Access to Care Initiative, 12 HIV service delivery organizations in New York implemented one of the following three interventions to improve linkage to and retention in HIV care at their site: Peer Support, Appointment Procedures, and Anti-Retroviral Treatment and Access to Services. Aggregate process measure data describing intervention delivery, in conjunction with qualitative findings to help explain barriers and facilitators to achieving full implementation were examined. Process data from the interventions showed shortcomings in the percentage of eligible patients who went on to be enrolled, and the number of enrollees who ultimately received the components of the interventions. Factors identified in qualitative interviews that facilitated implementation and intervention delivery included: concerted buy-in and coordination of staff, building upon existing infrastructure including ensuring sufficient staff capacity, and allowing adaptability of certain parts of the intervention to better fit patient needs and clinical settings.
KeywordsLinkage Retention HIV care interventions Process evaluation Implementation science
We would like to thank the organizations that implemented interventions: Iris House, Harlem Hospital, Institute for Family Health, North Shore University Hospital, Hudson River Healthcare, Open Door Family Medical Center, Evergreen Medical Center, Brooklyn Hospital Center-The PATH Center, Elmhurst Hospital Center, Jamaica Hospital, and Kaleida Women’s and Children’s Hospital. We also express our appreciation to NYLinks staff for their continued dedication to the initiative.
This project was supported by the Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) program under grant number H97HA22693: Systems Linkages and Access to Care for Populations at High Risk of HIV Infection initiative. The content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, SPNS or the U.S. Government.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
This study received a determination of Exempt status (exempt category #5) according to federal regulations, under 45 CFR 46.101(b). For the qualitative assessment, informed consent was obtained from all implementation staff included in the study.
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