title: HIV counseling, testing and referral experiences of persons diagnosed with HIV who have never entered HIV medical care.
abstract: The HIV counseling, testing, and referral (CTR) encounter represents an important opportunity to actively facilitate entry into medical care for those who test positive for HIV, but its potential is not always realized. Ways to improve facilitation of linkage to care through the CTR encounter haven't been explored among HIV-infected persons who have not entered care. We conducted 42 structured and qualitative interviews among HIV-infected persons, diagnosed 5-19 months previously, in Indiana, Philadelphia and Washington State, who had not received HIV medical care. Respondents related individual and system-level barriers, as well as recommendations for improving the effectiveness of CTR as a facilitator of linkage to HIV medical care through more active referrals, and for strengthening the bridge between CTR and linkage to care services. Our findings suggest that standards for active case referral by CTR staff and integration of CTR and linkage to care services are needed.
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. hge2@cdc.gov
authors.forename: Pamela Morse
authors.initials: PM
authors.lastname: Garland
authors.forename: Eduardo E
authors.initials: EE
authors.lastname: Valverde
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fagan
authors.forename: Linda
authors.initials: L
authors.lastname: Beer
authors.forename: Catherine
authors.initials: C
authors.lastname: Sanders
authors.forename: Daniel
authors.initials: D
authors.lastname: Hillman
authors.forename: Kathleen
authors.initials: K
authors.lastname: Brady
authors.forename: Maria
authors.initials: M
authors.lastname: Courogen
authors.forename: Jeanne
authors.initials: J
authors.lastname: Bertolli
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003376:Counseling; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult