Improving linkage to HIV care at low-threshold STI/HIV testing sites: An evaluation of the Immediate Staging Pilot Project in Vancouver, British Columbia

Abstract

OBJECTIVES:The objective of the Immediate Staging Pilot Project (ISPP) was to improve linkage to human immunodeficiency virus (HIV) care by increasing the number of referrals made to HIV care, and to decrease the time between diagnosis and linkage to care for newly diagnosed HIV clients. This pilot had the potential to decrease HIV transmission at a population level by engaging clients in treatment earlier. OUTCOMES: Comparing linkage to care outcomes between a group that received the standard of care (SOC) and an intervention group that received immediate staging, the median linkage to care time decreased from 21.5 to 14.0 days respectively (p = 0.053). The referral rates to HIV care were 56.1% in the SOC group and 94.1% in the intervention group (p < 0.001). CONCLUSION:Creating best practices that include offering CD4 and viral load testing at the time of diagnosis, enhanced nursing support and standardized referral processes has facilitated an improvement in the quality of HIV services provided to MSM clients attending low-threshold clinics.KEY WORDS: Linkage to care; continuum of care; HIV; men who have sex with men; low-threshold sites; outcome assessment (health care) La traduction du résumé se trouve à la fin de l'article.

A qualitative investigation of HIV treatment dispensing models and impacts on adherence among people living with HIV who use drugs

“…Within daily delivery, a health care professional hand-delivers a day's worth of medications to PLHIV at their home at a specified time each day, while daily pickup involves PLHIV travelling to a specific pharmacy each day to be dispensed their medications. Further, Vancouver is host to many HIV-specific programs and health services designed to be responsive to the needs of drug-using populations [27][28][29][30]. However, barriers to accessing and adhering to HIV treatment persist in this setting, which can complicate efforts to implement STTR [31][32][33], even within HIV specific housing programs [30].…”

Systematic Review and Meta-analysis of Linkage to HIV Care Interventions in the United States, Canada, and Ukraine (2010–2021)

“…Five studies were multiple component interventions that integrated CM/care coordination with either data-to-care [ 32 ]; text messaging reminders [ 36 ]; collaborations with local health departments to improve tracking and follow-up [ 39 ]; or bilingual case managers in department of health HIV testing facilities along with clinic reimbursement for initial HIV medical management [ 41 ]. One health care provider (HCP) study represented a nurse-led intervention to deliver HIV counseling and care coordination [ 33 ] and one study was structural, specifically legal policy mandating linkage to care [ 31 ].…”

“…Most studies were in the United States (n = 11), with the others in Canada (n = 1) [ 33 ] and Ukraine (n = 1) [ 36 ]. Three of the 13 studies specifically focused on sexual and gender minority populations [ 33 , 35 , 40 ].…”

“…Most studies were in the United States (n = 11), with the others in Canada (n = 1) [ 33 ] and Ukraine (n = 1) [ 36 ]. Three of the 13 studies specifically focused on sexual and gender minority populations [ 33 , 35 , 40 ]. Eligible populations in two studies specifically focused their intervention on racial/ethnic minorities: Kenya et al [ 37 ] in African Americans in Miami, Florida and Pitasi et al [ 40 ] focused enrollment of at least 50% of the sample from Blacks/African Americans or Hispanic/Latinos.…”

LGBTQ+ Aging Research in Canada: A 30-Year Scoping Review of the Literature

“…Much of the following research continued to be conducted in urban centres (namely Montreal, Toronto, and Vancouver) and nearly exclusively focused on MSM. With a strong health promotion framing, researchers evaluated interventions that improved referrals and reduced time between diagnosis and treatment for gay and bisexual men [ 51 ], including targeted rapid testing sites for immigrant MSM [ 52 ]. Focusing on prevention of infectious disease, Murry and Adam [ 53 ] conducted interviews with gay men in Toronto to understand the age-related components of safer-sex practices.…”