Characteristics of Out-of-Care Patients Who Required a Referral for Re-engagement Services by Public Health Bridge Counselors Following a Brief Clinic-Based Retention Intervention
The NC-LINK Project initiated both clinic-based retention services and state public health bridge counselor-based (SBCs) re-engagement services to retain and re-engage people living with HIV infection (PLWH) in care. The goal of this project is to compare efforts between clinic-based retention and SBC re-engagement services to determine whether patients are more or less likely to remain in HIV care services. Clinic appointment data were used to identify patients who were last seen more than 6–9 months prior. Patients either received clinic-based retention services only or were subsequently referred to the SBC re-engagement intervention if the retention services were unsuccessful. The frequency of re-engagement in care (180 days) and HIV suppression (VLS, within 1 year) was examined for patients in these two groups. The SBC group was less likely to have VLS at the visit prior to referral (adjusted OR 2.04, 95% CI 1.53, 2.72). Patients who were referred to the SBC were less likely to re-engage in care within 180 days as compared to those who received clinic-based retention services only (adjusted OR 0.29, 95% CI 0.21, 0.41).
KeywordsRetention in care HIV care Out-of-care Re-engagement Patient care
This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Systems Linkages for Access to Care Initiative H97HA22695. This information or 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, HHS or the U.S. Government. This study was conducted with the approval of the University & Medical Center Institutional Review Board at East Carolina University. The program was implemented as clinical care and did not require written consent. The authors also acknowledge the clinic staff, providers, and patients for their invaluable contributions to this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Health Resources and Services Administration.
All authors have contributed to the manuscript work, analysis, writing or editing and accept responsibility for publication. The authors also acknowledge the clinic staff, providers, and patients for their invaluable contributions to this research.
Compliance with Ethical Standards
Conflict of interest
None of the authors have conflicts of interest to report.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical Considerations for Animal Research: this article does not contain any studies with animals performed by any of the authors.
- 9.The Office of National AIDS Policy. National HIV/AIDS strategy for the United States: updated to 2020. 2015. https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf. Accessed 19 Oct 2016.
- 14.North Carolina Department of Health and Human Services. HIV continuum of care in North Carolina reported HIV case data. 2014. http://epi.publichealth.nc.gov/cd/stds/figures/factsheet_HIV_continuum_of_care_2014.pdf. Accessed 19 Oct 2016.
- 16.Swygard H, Sena AC, Mobley V, Clymore J, Sampson LA, Glenn K, et al. Implementation of a statewide team to facilitate linkage and re-engagement in HIV care in North Carolina. N C Med J. 2016 (In press).Google Scholar
- 17.Seña AC, Donovan J, Swygard H, Clymore J, Mobley V, Sullivan K, et al. The North Carolina HIV bridge counselor program: outcomes from a statewide level intervention to link and reengage HIV-infected persons in care in the South. J Acquir Immune Defic Syndr. 2017;76(1):e7–e14. https://doi.org/10.1097/QAI.0000000000001389.CrossRefPubMedGoogle Scholar
- 18.Health Resources and Services Administration. CAREWare. 2016. http://hab.hrsa.gov/program-grants-management/careware. Accessed 19 oct 2016.