Title

Predictors of Linkage to Care for Newly Diagnosed HIV-Positive Adults.

Document Type

Journal Article

Publication Date

7-1-2015

Journal

Western Journal of Emergency Medicine

Volume

16

Issue

4

Inclusive Pages

535-42

DOI

10.5811/westjem.2015.4.25345

Keywords

Delivery of Health Care--organization & administration; HIV Infections--drug therapy; Patient Compliance; Patient Participation

Abstract

INTRODUCTION: Linkage to care following a human immunodeficiency virus (HIV) diagnosis is critical. In the U.S. only 69% of patients are successfully linked to care, which results in delayed receipt of antiretroviral therapy leading to immune system dysfunction and risk of transmission to others.

METHODS: We evaluated predictors of failure to link to care at a large urban healthcare center in Philadelphia in order to identify potential intervention targets. We conducted a cohort study between May 2007 and November 2011 at hospital-affiliated outpatient clinics, emergency departments (EDs), and inpatient units.

RESULTS: Of 87 patients with a new HIV diagnosis, 63 (72%) were linked to care: 23 (96%) from the outpatient setting and 40 (63%) from the hospital setting (ED or inpatient) (p

CONCLUSION: Our findings demonstrate the comparative success of linkage to care in outpatient medical clinics versus hospital-based settings. This study both reinforces the importance of routine opt-out HIV testing in outpatient practices, and demonstrates the need to better understand barriers to linkage.

Comments

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Peer Reviewed

1

Open Access

1