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Using a Modeling-Based Approach to Assess and Optimize HIV Linkage to Care Services

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Abstract

Evidence-based linkage to care interventions (LTCs) help recently diagnosed HIV+ individuals engage in care in a timely manner yet are heavily impacted by the systems in which they are embedded. We developed a prototype agent-based model informed by data from an established LTC program targeting youth and young adults aged 13–24 in Memphis, Tennessee. We then tested two interventions to improve LTC in a simulated environment: expanding testing sites versus using current testing sites but improving direct referral to LTC staff from organizations providing testing, to understand the impact on timely linkage to care. Improving direct referral to the LTC program decreased days to successful linkage from an average of 30 to 23 days but expanding testing sites increased average days to 31 days unless those sites also made direct referrals. We demonstrated how LTC is impacted by the system and interventions for shortening days to linkage to care.

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Acknowledgements

This work has been supported primarily by the Center for Dissemination and Implementation in the Institute for Public Health at Washington University in St. Louis awarded to Dr. Virginia McKay; and in part by the National Institute of Mental Health Award Number R21MH115772-01 awarded to Dr. Virginia McKay, Ryan White Part B Award Number 140017060 and Ryan White Part D Award Number 151052030 awarded to Saint Jude Children’s Research Hospital.

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Authors and Affiliations

  1. Center for Public Health Systems Science, Brown School, Washington University in St. Louis, 1 Brookings Drive, Campus Box #1196, St. Louis, MO, 63130, USA

    V. R. McKay & T. B. Combs

  2. Department of Biology, Vassar College, Poughkeepsie, NY, USA

    C. L. Cambey

  3. Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, USA

    A. W. Stubbs & A. H. Gaur

  4. Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA

    L. C. Pichon

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  1. V. R. McKay
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Correspondence to V. R. McKay.

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McKay, V.R., Cambey, C.L., Combs, T.B. et al. Using a Modeling-Based Approach to Assess and Optimize HIV Linkage to Care Services. AIDS Behav 25, 886–896 (2021). https://doi.org/10.1007/s10461-020-03051-5

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