title: Linkage and Referral to HIV and Other Medical and Social Services: A Focused Literature Review for Sexually Transmitted Disease Prevention and Control Programs.
abstract: BACKGROUND
  Sexually transmitted disease (STD) program and clinic staff play an important role in providing linkage and referrals to programs and services that address the complex medical and psychosocial needs of their clients. We synthesized recent published literature related to effective practices for linkage to care for HIV and referral to other medical and social services.
  
  
  METHODS
  Three PubMed searches were conducted to identify relevant studies published since 2004 on (1) linkage to HIV care, (2) referral within STD clinical contexts, and (3) (review articles only) referral practices among all medical specialties. Systematic review procedures were not used.
  
  
  RESULTS
  Thirty-three studies were included in this review. Studies highlight the limited value of passive referral practices and the increased effectiveness of active referral and linkage practices. Numerous studies on linkage to HIV care suggest that case management approaches, cultural-linguistic concordance between linkage staff and clients, and structural features such as colocation facilitate timely linkage to care. Integration of other medical and social services such as family planning and alcohol screening services into STD settings may be optimal but resource-intensive. Active referral practices such as having a written referral protocols and agreements, using information technology to help transfer information between providers, and making appointments for clients may offer some benefit. Few studies included information on program costs associated with linkage and referral.
  
  
  CONCLUSIONS
  Recent literature provides some guideposts for STD program and clinical staff to use in determining their approach to helping link and refer clients to needed care. Much experience with these issues within STD services remains unpublished, and key gaps in the literature remain.
authors.affiliation: From the Divisions of *STD Prevention and †HIV/AIDS Prevention, CDC, Atlanta, GA; ‡San Francisco Department of Public Health, San Francisco, CA; and §School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Marion W
authors.initials: MW
authors.lastname: Carter
authors.forename: Hsiu
authors.initials: H
authors.lastname: Wu
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cohen
authors.forename: Lisa
authors.initials: L
authors.lastname: Hightow-Weidman
authors.forename: Shirley Lee
authors.initials: SL
authors.lastname: Lecher
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Peters
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D020000:Decision Support Systems, Clinical; D003695:Delivery of Health Care / Q000458:organization & administration*; D005193:Family Planning Services; D006801:Humans; D016247:Information Storage and Retrieval; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology