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

This is an open access PMC article. Click the link for full text access.

Peer Reviewed

1

Open Access

1

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