title: The North Carolina HIV Bridge Counselor Program: Outcomes From a Statewide Level Intervention to Link and Reengage HIV-Infected Persons in Care in the South.
abstract: To improve the HIV continuum of care, a team of field service interventionists (State Bridge Counselors, SBC) was developed through a state public health system and provided brief (1-2) contacts for linkage of newly diagnosed persons with HIV and reengagement of persons living with HIV (PLWH) who were not in care.
  
  
  
  North Carolina, United States.
  
  
  
  Service data from January 2013 to June 2015 were analyzed to determine characteristics of clients referred to SBCs, proportions linked or reengaged in care, and/or achieved viral load suppression (VLs). We evaluated associations between client characteristics and outcomes using multivariable analyses and estimated odds ratios (OR) with 95% confidence intervals (CI).
  
  
  
  SBCs provided linkage services to 299 newly diagnosed individuals and reengagement services to 606 PLWH throughout North Carolina. Among persons who received linkage services, 189 (63%) had evidence of care within 90 days of referral and 205 (69%) had VLs within a year. Among PLWH who received reengagement services, 278 (46%) had care within 90 days and 308 (51%) had VLs within a year. Persons aged 30-39 years (OR, 2.1; 95% CI, 1.1 to 3.9) and 40-49 years had an increased likelihood (OR, 2.4; 95% CI, 1.1 to 5.2) of linkage within 90 days compared with persons aged 18-29 years. Non-white PLWH had an increased OR of 1.7; (95% CI, 1.2 to 2.5) of reengagement compared with whites.
  
  
  
  Our SBC program successfully implemented a "low-touch" approach to provision of linkage and reengagement services, demonstrating that public health resources can be used to address the HIV care continuum on a statewide level.
authors.affiliation: *Department of Medicine, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC; †NC Department of Health and Human Services, Communicable Disease Branch, Raleigh, NC; and ‡Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC.
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Seña
authors.forename: Jenna
authors.initials: J
authors.lastname: Donovan
authors.forename: Heidi
authors.initials: H
authors.lastname: Swygard
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Clymore
authors.forename: Victoria
authors.initials: V
authors.lastname: Mobley
authors.forename: Kristen
authors.initials: K
authors.lastname: Sullivan
authors.forename: Anna
authors.initials: A
authors.lastname: LeViere
authors.forename: Amy
authors.initials: A
authors.lastname: Heine
authors.forename: Evelyn B
authors.initials: EB
authors.lastname: Quinlivan
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D003266:Continuity of Patient Care / Q000458:organization & administration*; D000072117:Counselors; D037001:Directive Counseling / Q000458:organization & administration*; D005006:Ethnicity; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D012944:Social Support; D019562:Viral Load