Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure

Giordano, Thomas P.; Visnegarwala, Fehmida; White, A. Clinton; Troisi, Catherine L; Frankowski, Ralph F.; Hartman, Christine M.; Grimes, Richard M.

doi:10.1080/09540120412331336652

Cited by 139 publications

(136 citation statements)

References 20 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…35,39,40 Other studies indicate that adolescents and young adults are less likely to link and remain in care than older adults. [40][41][42] Some studies using different age ranges for analysis found no difference in linkage in younger adults. 35,[43][44][45] However, combining published data from these studies (Table 1), we estimate that 62% of newly diagnosed HIV-infected adolescents and young adults in the United States link to care within the first 6-12 months.…”

Section: Linkage To Carementioning

confidence: 99%

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

Zanoni

Mayer²

2014

AIDS Patient Care and STDs

359

315

View full text Add to dashboard Cite

Little is known about how adolescents and young adults contribute to the declines in the cascade of care from HIV-1 diagnosis to viral suppression. We reviewed published literature from the Unites States reporting primary data for youth (13-29 years of age) at each stage of the HIV cascade of care. Approximately 41% of HIVinfected youth in the United States are aware of their diagnosis, while only 62% of those diagnosed engage medical care within 12 months of diagnosis. Of the youth who initiate antiretroviral therapy, only 54% achieve viral suppression and a further 57% are not retained in care. We estimate less than 6% of HIV-infected youth in the United States remain virally suppressed. We explore the cascade of care from HIV diagnosis through viral suppression for HIV-infected adolescents and young adults in the United States to highlight areas for improvement in the poor engagement of the infected youth population.

show abstract

Section: Linkage To Carementioning

confidence: 99%

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

Zanoni

Mayer²

2014

AIDS Patient Care and STDs

359

315

View full text Add to dashboard Cite

show abstract

“…YLHIV are more likely to disengage from care, delay initiation of antiretroviral therapy (ART), and have lower rates of virologic suppression on ART. [3][4][5][6][7][8][9] YLHIV face barriers to care that are unique to the developmental period of adolescence and young adulthood. 10,11 Like many youth with chronic illness, YLHIV must learn to cope with a chronic medical condition at a time when most peers are healthy.…”

mentioning

confidence: 99%

The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth

Lee

Yehia

Gaur

et al. 2016

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Limited data exist on how structures of care impact retention among youth living with HIV (YLHIV). We describe the availability of youth-friendly structures of care within HIV Research Network (HIVRN) clinics and examine their association with retention in HIV care. Data from 680 15-to 24-year-old YLHIV receiving care at 7 adult and 5 pediatric clinics in 2011 were included in the analysis. The primary outcome was retention in care, defined as completing ‡2 primary HIV care visits ‡90 days apart in a 12-month period. Sites were surveyed to assess the availability of clinic structures defined a priori as 'youth-friendly'. Univariate and multivariable logistic regression models assessed structures associated with retention in care. Among 680 YLHIV, 85% were retained. Nearly half (48%) of the 680 YLHIV attended clinics with youth-friendly waiting areas, 36% attended clinics with evening hours, 73% attended clinics with adolescent health-trained providers, 87% could email or text message providers, and 73% could schedule a routine appointment within 2 weeks. Adjusting for demographic and clinical factors, YLHIV were more likely to be retained in care at clinics with a youth-friendly waiting area (AOR 2.47, 95% CI [1.11-5.52]), evening clinic hours (AOR 1.94; 95% CI [1.13-3.33]), and providers with adolescent health training (AOR 1.98; 95% CI [1.01-3.86]). Youth-friendly structures of care impact retention in care among YLHIV. Further investigations are needed to determine how to effectively implement youth-friendly strategies across clinical settings where YLHIV receive care.

show abstract

“…To date, with two exceptions, 33,37 studies of barriers to HIV care entry have been retrospective. [38][39][40][41][42][43][44] Never in Care Pilot interviews with people who had not yet entered care at the time of the interview show that barriers to care are multidimensional, and indicate that poverty and mental health problems may be contributing factors, underscoring the importance of supportive services to help with starting and staying in care.…”

Section: Discussionmentioning

confidence: 99%

Missed Connections: HIV-Infected People Never in Care

et al. 2013

View full text Add to dashboard Cite

Objective. Clinical interventions that lengthen life after HIV infection and significantly reduce transmission could have greater impact if more HIV-diagnosed people received HIV care. We tested a surveillance-based approach to investigating reasons for delayed entry to care. Methods. Health department staff in three states and two cities contacted eligible adults diagnosed with HIV four to 24 months previously who had no reported CD4+ lymphocyte (CD4) or viral load (VL) tests. The staff conducted interviews, performed CD4 and VL testing, and provided referrals to HIV medical care. Reported CD4 and VL tests were prospectively monitored to determine if respondents had entered care after the interview. Results. Surveillance-based follow-up uncovered problems with reporting CD4 and VL tests, resulting in surveillance improvements. However, reporting problems led to misspent effort locating people who were already in care Follow-up proved difficult because contact information in surveillance case records was often outdated or incorrect. Of those reached, 37% were in care and 29% refused participation. Information from 132 people interviewed generated ideas for service improvements, such as emphasizing the benefits of early initiation of HIV care, providing coverage eligibility information soon after diagnosis, and leveraging other medical appointments to provide assistance with linkage to HIV care. Conclusions. Surveillance-based follow-up of HIV-diagnosed individuals not linked to care provided information to improve both surveillance and linkage services, but was inefficient because of difficulties identifying, locating, and recruiting eligible people. Inefficiencies attributable to missing, incomplete, or inaccurate surveillance records are likely to diminish as data quality is improved through ongoing use.

show abstract

Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure

Cited by 139 publications

References 20 publications

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth

Missed Connections: HIV-Infected People Never in Care

Contact Info

Product

Resources

About