title: Lost or just not following up: public health effort to re-engage HIV-infected persons lost to follow-up into HIV medical care.
abstract: OBJECTIVE
  Locate persons living with HIV (PLWH) presumed lost to follow-up (LTFU), and assist them with partner services and linkage to HIV-related care.
  
  
  METHODS
  Locate and facilitate re-engagement in care for PLWH-LTFU in New York City (NYC), with longitudinal follow-up using HIV surveillance registry.
  
  
  METHODS
  HIV care facilities and communities in NYC.
  
  
  METHODS
  PLWH, reported in the NYC HIV surveillance registry, who had a NYC care provider and residential address at last report in the registry. Presumed-LTFU was defined as having no CD4+ or viral load during the most recent 9 months during the study period July 2008-December 2010.
  
  
  METHODS
  Case-workers conducted public health investigation to locate PLWH presumed-LTFU and offered them assistance with partner and linkage-to-care services.
  
  
  METHODS
  Results of partner and linkage-to-care services, and reasons for LTFU.
  
  
  RESULTS
  From July 2008 to December 2010, 797 PLWH presumed-LTFU were prioritized for investigation; 14% were never located. Of the 689 located, 33% were current to care, 5% had moved or were incarcerated, 2% had died, and 59% (409) were verified to be LTFU. Once located, 77% (315/409) accepted clinic appointments, and 57% (232/409) returned to care. Among the 161 who provided reasons for LTFU, the most commonly reported was 'felt well' (41%).
  
  
  CONCLUSIONS
  Health department case-workers helped more than half PLWH-LTFU re-engage in HIV medical care. HIV prevention strategies must include efforts to re-engage PLWH-LTFU in care, for treatment consideration under current treatment guidelines to improve their clinical status and decrease transmission risk.
authors.affiliation: HIV Epidemiology and Field Services Program, New York City Department of Health and Mental Hygiene, New York, New York, USA.
authors.forename: Chi-Chi N
authors.initials: CC
authors.lastname: Udeagu
authors.forename: Tashonna R
authors.initials: TR
authors.lastname: Webster
authors.forename: Angelica
authors.initials: A
authors.lastname: Bocour
authors.forename: Pierre
authors.initials: P
authors.lastname: Michel
authors.forename: Colin W
authors.initials: CW
authors.lastname: Shepard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011635:Public Health Administration / Q000379:methods*; D012042:Registries; D055815:Young Adult