Project Engage: Snowball Sampling and Direct Recruitment to Identify and Link Hard-to-Reach HIV-Infected Persons Who Are Out of Care

Abstract

The alternative approaches presented were effective at locating marginalized HIV-positive persons who are OOC for linkage and retention. The SNR approach was most successful at identifying alters with serious social challenges and gaps in needed medical/ancillary services.

Is HIV patient navigation associated with HIV care continuum outcomes?

“…Target populations were primarily PWH who had challenges being engaged in HIV care. Examples include PWH with a history of incarceration (n=8) [11, 14-17, 19-21], with recent/new HIV diagnosis (n=5) [10, 14, 18, 20-21], with comorbid conditions such as substance use and mental health problems (n=4) [10, 13, 19, 22], and those who were veterans (n=1) [23], women (n=1) [8], or racial minorities (n=1) [10].…”

“…Seventeen out of the 20 studies (85%) [5, 8-9, 11-12, 14-21, 23-26] reported any positive associations between patient navigation and any HIV care continuum outcome. Except for the three studies that did not provide statistical tests [14, 16, 20], all of the positive associations were statistically significant.…”

“…Studies that included PWH with poor engagement in care as evidenced by, for example, lapse in documented HIV care, aimed to and successfully re-linked and/or retained them in HIV care [5, 8-9, 14, 20, 24-26]. Many of these programs also reported significant positive associations with viral suppression [5, 12, 14, 19-21, 23-25]. Outreach to those who are out of care, assisting with scheduling appointments, appointment reminders, assistance with transportation and accompaniment to a clinic visit were common across these programs.…”

“… 1 CBO=community based organization 2 Intervention Group: Sample=women who used heroin and/or acknowledged mental health problems; Six months of transportation service plus navigator, followed by 6 months of transportation only. Comparison Group: Sample=women who did not use heroin nor acknowledge mental health problems; Transportation only for 12 months. 3 VA Medical Center 4 HIV clinic 5 FTE=full time equivalent 6 IQR=interquartile range 7 HR=hazard ratio 8 CI=confidence interval 9 RR=relative risk 10 HRSA=Health Resources and Services Administration 11 Ryan White Part C clinic 12 RCT=randomized controlled trial 13 Public health clinics, testing centers, hospital inpatient, Emergency Room/walk-in clinics, drug treatment center 14 ARTAS (Antiretroviral Treatment Access Study) 15 Hospitals 16 Information was provided in the “Care Coordination for People with HIV Program Manual Version 5.0” Issued by the New York City Department of Health and Mental Hygiene. 17 In stratified analyses, the significant improvements for retention was generally held across subgroups. 18 In stratified analyses, the significant improvement for viral suppression was generally held across subgroups. 19 Hospitals 20 Only the previously diagnosed were included in the outcome analysis. 21 In stratified analyses, significant improvements in retention were observed in all subgroups (including those with lower mental health functioning, unstable housing, or hard drug use). 22 In stratified analyses, significant improvements in viral suppression were observed in all subgroups (including those with lower mental health functioning, unstable housing, or hard drug use). 23 DOC = Department of Correction 24 GEE=generalized estimating equation 25 Hospital system, STD clinics, primary care clinics 26 PWH=persons with HIV 27 Chicago: Administrative records, surveillance data, lab records; Louisiana: State surveillance data; New York City: Managed care plan claims data 28 Hospitals 29 The study reported ART uptake findings from medical records but medical records were not available in about 25~30% of the samples, and thus were not considered in this review. 30 AOR=adjusted odds ratio 31 Hospitals 32 ARTAS=Antiretroviral Treatment Access Study [21] …”

The influence of minority stress on indicators of suicidality among lesbian, gay, bisexual and transgender adults in Thailand

“…In addition, study participants were asked to inform their friends about the research opportunity. These activities represented established best practices for recruitment of hidden and hard to reach populations (Wohl et al., 2017).…”