A systematic review of health service interventions to improve linkage with or retention in HIV care

Brennan, Aline; Browne, John; Horgan, Mary

doi:10.1080/09540121.2013.869536

Cited by 47 publications

(37 citation statements)

References 40 publications

(63 reference statements)

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“…[28][29][30][31][32] Given the increasing pressure to manage large panels of complex patients in a manner that produces optimal outcomes with minimal use of resources, identifying ways to conduct population-level triage remains critical. In addition to predicting the magnitude of risk for missing the next appointment, this tool stratified a large cohort of over 500 patients with unsuppressed viremia based on severity of risk.…”

Section: Discussionmentioning

confidence: 99%

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Woodward

Person²,

Rebeiro³

et al. 2015

AIDS Patient Care and STDs

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Successful treatment of HIV infection requires regular clinical follow-up. A previously published risk-prediction tool (RPT) utilizing data from the electronic health record (EHR) including medication adherence, previous appointment attendance, substance abuse, recent CD4 + count, prior antiretroviral therapy (ART) exposure, prior treatment failure, and recent HIV-1 viral load (VL) has been shown to predict virologic failure at 1 year. If this same tool could be used to predict the more immediate event of appointment attendance, high-risk patients could be identified and interventions could be targeted to improve this outcome. We conducted an observational cohort study at the Vanderbilt Comprehensive Care Clinic from August 2013 through March 2014. Patients with routine medical appointments and most recent HIV-1 VL > 200 copies/mL were included. Risk scores for a modified RPT were calculated based on data from the EHR. Odds ratios (OR) for missing the next appointment were estimated using multivariable logistic regression. Among 510 persons included, median age was 39 years, 74% were male, 55% were black, median CD4 + count was 327 cells/mm 3 [Interquartile Range (IQR): 142-560], and median HIV-1 VL was 21,818 copies/mL (IQR: 2,030-69,597). Medium [OR 3.95, 95% confidence interval (CI) 2.08-7.50, p-value < 0.01] and high (OR 9.55,, p-value < 0.01) vs. low RPT risk scores were independently associated with missing the next appointment. RPT scores, constructed using readily available data, allow for risk-stratification of HIV medical appointment non-attendance and could support targeting limited resources to improve appointment adherence in groups most at-risk of poor HIV outcomes.

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Section: Discussionmentioning

confidence: 99%

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Woodward

Person²,

Rebeiro³

et al. 2015

AIDS Patient Care and STDs

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“…Unlike other HTC strategies, the providerclient interaction is limited or totally absent in self-testing and interventions to improve care seeking such as strengths-based case management, intensive posttest counseling, and motivational interviewing may not be feasible. 24 Additionally, clients who choose to self-test may exhibit different health-seeking behaviors from clients who undergo provider-supervised testing. Indeed these clients may require a deeper level of personal involvement in the interpretation and access to care compared to other HTC strategies.…”

Section: Introductionmentioning

confidence: 99%

HIV Self-testing in Sub-Saharan Africa: Strategies to Enhance and Measure Linkage to Care

Cherutich

Kurth²,

Musyoki³

et al. 2014

RRT

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HIV self-testing is gaining traction as an additional strategy for increasing access to knowledge of HIV status in sub-Saharan Africa. This approach may reinforce individual autonomy and is potentially more convenient compared to other HIV testing techniques. Given the global push toward early antiretroviral therapy, HIV self-testing may appear ineffective in assuring linkage to HIV care. Approaches to improve this critical outcome of HIV self-testing include utilization of unique personal identifiers, fingerprint scanning, phone-based reminders and queries, and centralized databases to follow up clients who test themselves. To enable jurisdictions in sub-Saharan Africa to measure coverage of HIV self-testing and the associated linkage to care, the centralized databases ought to be linked to HIV care clinic data. Current information systems like household surveys can also be adapted for surveillance of linkage to care post self-testing. However, the affordability and cost-effectiveness of these innovations need to be evaluated. Since self-testing is a new behavior, a deeper understanding of the trajectory of clients after testing is necessary in order to design appropriate interventions for linkage to care. Policy makers, implementers, researchers, and technology experts in sub-Saharan Africa should seize the opportunity to scale-up high-quality self-testing programs, improve the HIV care cascade, and contribute to the decline of new HIV infections. KEY WORDS:HIV, self-testing, linkage to care, surveillance, implementation science CITATION: cherutich et al. hiv self-testing in sub-saharan africa: strategies to enhance and measure linkage to care.

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“…Health system strategies and HIV service delivery interventions such as counselling, brief case management (54,55). The fact that some patients were not aware of their HIV disease status until the development of opportunistic infections might also reflect low education and lack of awareness about the risk of HIV transmission.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013

Shalaka

Garred

Zeglam

et al. 2015

Easter Mediterr Health J

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In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/µL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality. . Le diagnostic le plus fréquent était la candidose (26,0 %) ; la pneumonie à Pneumocystis était la maladie respiratoire la plus fréquente (8,8 %), tandis que la toxoplasmose cérébrale était diagnostiquée chez 8,4 % des patients). Un traitement antirétroviral hautement actif en cours était indépendamment associé à un faible risque de mortalité en milieu hospitalier (OR 0,33), tandis que les symptômes du système nerveux central (OR 4,12), la septicémie (OR 6,98) et les faibles numérations lymphocytaires totales (OR 3,60) étaient associés à un risque accru. Dans cette étude, une présentation tardive accompagnée d'une immunosuppression sévère était fréquente, et était associée à une mortalité élevée en milieu hospitalier.

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A systematic review of health service interventions to improve linkage with or retention in HIV care

Cited by 47 publications

References 40 publications

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

Risk Prediction Tool for Medical Appointment Attendance Among HIV-Infected Persons with Unsuppressed Viremia

HIV Self-testing in Sub-Saharan Africa: Strategies to Enhance and Measure Linkage to Care

Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013

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