Retention in care of persons newly diagnosed with HIV: outcomes of the Outreach Initiative.
The purpose of this study was to contribute to the limited literature on newly diagnosed persons living with HIV/AIDS (PLWHA) by describing their retention in HIV primary care and changes in barriers to care over 12 months of follow-up subsequent to enrolling in outreach interventions. Medical chart review and interview data were collected from 104 newly diagnosed PLWHA at baseline, 6-month, and 12-month follow-up. Almost all newly diagnosed PLWHA (92%) had an HIV care appointment in the 6 months post-enrollment. Newly diagnosed persons were more likely to have undetectable viral loads at 6 and 12-month follow-up compared to baseline with 45% undetectable by 12 months. Adequate retention in care (at least one appointment in each 6-month window) was significantly associated with reductions in substance use and improvements in insurance coverage. Improvements in mental health status and the elimination of stigma as a barrier were not associated with retention, but those who reported stigma as a barrier at baseline and continued to report stigma at 6 months had less than adequate retention. These results suggest the need for early and intensive outreach interventions for newly diagnosed persons. Future directions include testing outreach interventions in a randomized clinical trial, and evaluating programs that integrate early HIV identification and intensive outreach to enroll and retain persons newly infected with HIV in care.
Naar-King
Sylvie
S
Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, Michigan 48201, USA. snaarkin@med.wayne.edu
Bradford
Judith
J
Coleman
Sharon
S
Green-Jones
Monique
M
Cabral
Howard
H
Tobias
Carol
C
D000328:Adult; D003159:Community-Institutional Relations; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000706:statistics & numerical data; D011584:Psychology; D013997:Time Factors