title: Come as You Are: Improving Care Engagement and Viral Load Suppression Among HIV Care Coordination Clients with Lower Mental Health Functioning, Unstable Housing, and Hard Drug Use.
abstract: Lower mental health functioning, unstable housing, and drug use can complicate HIV clinical management. Merging programmatic and surveillance data, we examined characteristics and outcomes for HIV Care Coordination clients enrolled between December 2009 and March 2013. For clients diagnosed over 12 months before enrollment, we calculated post- versus pre-enrollment relative risks for short-term (12-month) care engagement and viral suppression. Both outcomes significantly improved in all subgroups, including those with lower mental health functioning, unstable housing, or hard drug use. Analyses further stratified within barrier-affected groups showed a tendency toward greater improvement when that barrier was reduced during the follow-up year.
authors.affiliation: The Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, New York, NY, 11101-4132, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Irvine
authors.affiliation: The Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, New York, NY, 11101-4132, USA. stephanne.nyc@gmail.com.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Chamberlin
authors.affiliation: The Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, New York, NY, 11101-4132, USA.
authors.forename: Rebekkah S
authors.initials: RS
authors.lastname: Robbins
authors.affiliation: Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, 10027, NY, USA.|Institute for Implementation Science in Population Health, The City University of New York, 55 West 125th Street, New York, 10027, NY, USA.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Kulkarni
authors.affiliation: Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, 10027, NY, USA.
authors.forename: McKaylee M
authors.initials: MM
authors.lastname: Robertson
authors.affiliation: Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, New York, 10027, NY, USA.|Institute for Implementation Science in Population Health, The City University of New York, 55 West 125th Street, New York, 10027, NY, USA.
authors.forename: Denis
authors.initials: D
authors.lastname: Nash
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006798:Housing; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008603:Mental Health; D017063:Outcome Assessment, Health Care; D064890:Social Determinants of Health; D019966:Substance-Related Disorders / Q000523:psychology*; D019562:Viral Load / Q000187:drug effects*
keywords: Case management; HIV surveillance; Outcomes research; Psychosocial factors; Viral load