scholarly journals Identifying African American Women with HIV Infection in an Expanded HIV testing and Linkage to Care (X-TLC) Program in Healthcare Settings on the South and West Sides of Chicago.

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S425-S426
Author(s):  
Moira C McNulty ◽  
Ellen Almirol ◽  
Jessica P Ridgway ◽  
Jessica Schmitt ◽  
Rebecca Eavou ◽  
...  
Keyword(s):  
Gender Differences ◽  
African American ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Linkage To Care ◽  
Academic Community ◽  
The South ◽  
Healthcare Settings ◽  
Grant Recipient ◽  
Women With Hiv

Abstract Background Women account for 25 % of HIV infections nationally, and African American (AA) women are disproportionately affected. We report important gender differences observed in an expanded HIV testing and linkage to care (X-TLC) program conducted on the South and West Sides of Chicago. Methods X-TLC is funded by CDPH with CDC prevention B funds. X-TLC has expanded from 3 sites to 14 sites, including acute care hospitals (academic, community), community health centers (CHCs), and family planning clinics. We report descriptive stats, group comparisons by Chi-square, and multivariate analyses adjusted for demographics. Results Since 2011, X-TLC has conducted 308,038 HIV screens, and 63.7 % of those tested were women. Overall seroprevalence for HIV was 0.56 %, and 30.5 % of HIV patients identified were cis-gender women (seroprevalence 0.15 %). The seroprevalence for women testing in EDs was higher (0.44 %). Similar to men, only 52.9 % of HIV positive women were new diagnoses. Women accounted for 28.5 % of all new diagnoses, compared with 15.4 % for Chicago overall. In 2016 X-TLC screened 91,865 persons for HIV, and 65.2 % of those tested were women. There were 193 new diagnosis and 32.1 % (62) were women, 85.7 % AA. In comparison, in 2015 there were 139 women with a new HIV diagnosis for all of Chicago. Women newly diagnosed were less likely to be linked to care (adjusted odds ratio, aOR, 0.54, 0.35–0.85). Linkage was lower for women diagnosed at CHCs (84.6 % vs. 76.3 %, P = 0.02). Most CHCs did not have on site HIV providers. At our site, however, women linked to care were more likely to be retained in care (aOR 0.58, 0.43–0.78). We also conduct targeted outreach testing, partner services (PS) testing, and social network strategy (SNS) testing, but women are not identified by these programs (16/171 tested women, 8 new diagnoses were men for PS; 507 tested, 471 men and 36 trans-gender women, 38 new positives, 0 cis-gender women for SNS). Conclusion More women than men were offered and/or accept HIV screening in healthcare settings. The proportion of seropositive women identified was higher than the national average. X-TLC is reaching a large proportional of AA women with HIV unaware of their status. Other testing strategies will rarely identify cis-gender women with HIV infection. Gender differences in linkage to and retention in care will require strategies targeted at women. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; N. Glick, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient

scholarly journals Gender Differences in HIV Testing, Diagnosis, and Linkage to Care in Healthcare Settings: Identifying African American Women with HIV in Chicago

2018 ◽  
Vol 32 (10) ◽  
pp. 399-407 ◽  
Author(s):  
Ellen A. Almirol ◽  
Moira C. McNulty ◽  
Jessica Schmitt ◽  
Rebecca Eavou ◽  
Michelle Taylor ◽  
...  
Keyword(s):  
Gender Differences ◽  
African American ◽  
Hiv Testing ◽  
African American Women ◽  
Linkage To Care ◽  
American Women ◽  
Healthcare Settings ◽  
Women With Hiv

scholarly journals Predictors Of Provider-Initiated Hiv Testing In Heterosexuals At Increased Risk Of Hiv (Het) In Puerto Rico: Data From Nhbs-Het Cycle 2016

2020 ◽  
Author(s):  
Maureen Marie Canario de la Torre ◽  
Ivony Yireth Agudelo Salas ◽  
Sandra Miranda de León ◽  
Yadira Rolón Colón ◽  
María Pabón Martínez ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Puerto Rico ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Perceived Risk ◽  
Healthcare Providers ◽  
World Health ◽  
Healthcare Settings ◽  
Hiv Test ◽  
Increased Risk

Abstract The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have established guidelines for HIV testing in healthcare settings. The aim of this study was to identify the sociodemographic, healthcare, and sexual-behavior predictors of provider-initiated HIV testing (PIHT) using data from the Puerto Rico National HIV Behavioral Surveillance (PR-NHBS) 2016 cycle directed towards heterosexuals at increased risk of HIV infection (HET). A total sample of 531 eligible participants were recruited through respondent-driven sampling (RDS). Logistic regression models assessed the associations between sociodemographic, healthcare, and sexual-behavior predictors, whilst adjusting for sex and age. The majority of the participants were women (66.1%), with 72.7% reporting having received healthcare services in the past year. Of them, 18.7% had received an HIV-test offer from their healthcare providers. More than half of the participants (65.2%) reported a low perceived risk of getting infected with HIV in the next 12 months. Results suggest an overall low prevalence of PIHT among HET in PR who exhibited a relatively high prevalence of low perceived risk of HIV infection. Furthermore, the assessed predictors show that individuals who engaged in high-risk sexual behaviors (AOR = 0.52; 95% CI: 0.30–0.90) were less likely to receive HIV-test offers from their providers. This study further emphasizes the need for healthcare providers to follow recommended guidelines for HIV testing in healthcare settings as a means of establishing preventive measures to further counteract the HIV epidemic in Puerto Rico, specifically among HET.

scholarly journals Implementing Rapid Initiation of Antiretroviral Therapy for Acute HIV Infection Within a Routine Testing and Linkage to Care Program in Chicago

2020 ◽  
Vol 19 ◽  
pp. 232595822093975
Author(s):  
Moira McNulty ◽  
Jessica Schmitt ◽  
Eleanor Friedman ◽  
Bijou Hunt ◽  
Audra Tobin ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Viral Suppression ◽  
Linkage To Care ◽  
Care Program ◽  
Acute Hiv Infection ◽  
Screening Programs ◽  
Acute Hiv ◽  
Therapy Clients

Growing evidence suggests that rapid initiation of antiretroviral therapy for HIV improves care continuum outcomes. We evaluated process and clinical outcomes for rapid initiation in acute HIV infection within a multisite health care–based HIV testing and linkage to care program in Chicago. Through retrospective analysis of HIV testing data (2016-2017), we assessed linkage to care, initiation of antiretroviral therapy, and viral suppression. Of 334 new HIV diagnoses, 33 (9.9%) individuals had acute HIV infection. Median time to linkage was 11 (interquartile range [IQR]: 5-19.5) days, with 15 days (IQR 5-27) to initiation of antiretroviral therapy. Clients achieved viral suppression at a median of 131 (IQR: 54-188) days. Of all, 69.7% were retained in care, all of whom were virally suppressed. Sites required few additional resources to incorporate rapid initiation into existing processes. Integration of rapid initiation of antiretroviral therapy into existing HIV screening programs is a promising strategy for scaling up this important intervention.

scholarly journals 1273. Routine Opt-out HIV Screening and Detection of HIV Infection Among Emergency Department Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S388-S388
Author(s):  
Nada Fadul ◽  
Ciarra Dortche ◽  
Richard Baltaro ◽  
Tim Reeder
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Medical Center ◽  
Linkage To Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Opt Out ◽  
Post Test

Abstract Background The Southeastern United States bears a disproportionate burden of HIV infection, accounting for nearly half of all new cases. The Centers for Disease Control and Prevention released routine opt-out testing recommendations in 2006. Our emergency department collaborated with our infectious diseases clinic (ECU-ID) to implement suggested guidelines among adults since March 2017. Methods Our primary aim was to implement routine, opt-out HIV testing in the Vidant Medical Center Emergency Department (ED) for patients between 18 and 65 years of age who have blood work completed, and have not had a test documented in the electronic medical record (EMR) in the last year. A secondary aim was to successfully link HIV-positive patients to care at ECU-ID or preferred clinic. Methods defining programmatic success included developing nurse directed opt-out ordering protocol, integrating testing into normal ED workflow, utilizing the existing EMR to prompt testing, and hiring a linkage coordinator to initiate post-test counseling and linkage-to-care. Results Since March 2, 2017, a total of 7,109 HIV tests were performed; an average of 592 monthly tests conducted compared with a previous average of 10 stat tests. Testing increased 5,820% compared with 2015. Of the 21 HIV-positive patients found, 16 were newly diagnosed. Among those newly diagnosed, 14 (87.5%) were linked to care; and among the five known positives, two (40%) were linked to care. Reasons why patients could not be linked included incarceration, refusal to link to care, and re-location. Conclusion Joined with the implementation of a routinized ED HIV testing program, a seamless process was developed to link persons found to be positive in the ED to HIV care services; therefore, establishing a systems-level prevention model. Future plans include expanding testing to adolescents and utilizing similar methods to integrate Hepatitis C testing. Disclosures All Authors. Gilead Sciences, Inc.: Grant Investigator, Grant recipient and Salary.

scholarly journals African American church-based HIV testing and linkage to care: assets, challenges and needs

2015 ◽  
Vol 18 (6) ◽  
pp. 669-681 ◽  
Author(s):  
Jennifer M. Stewart ◽  
Keitra Thompson ◽  
Christopher Rogers
Keyword(s):  
African American ◽  
Hiv Testing ◽  
Linkage To Care ◽  
African American Church

scholarly journals Use of Social Network Strategy Among Young Black Men Who Have Sex With Men for HIV Testing, Linkage to Care, and Reengagement in Care, Tennessee, 2013-2016

2018 ◽  
Vol 133 (2_suppl) ◽  
pp. 43S-51S ◽  
Author(s):  
Shanell L. McGoy ◽  
April C. Pettit ◽  
Melissa Morrison ◽  
Leah R. Alexander ◽  
Phadre Johnson ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Black Men ◽  
Linkage To Care ◽  
The United States ◽  
High Risk Population ◽  
Newly Diagnosed ◽  
Sex With Men

Objectives: Tennessee was 1 of 8 states that received funding from the Care and Prevention in the United States Demonstration Project, which aimed to reduce HIV-related morbidity and mortality among racial/ethnic and sexual minority populations. The objective of this study was to describe implementation of a social network strategy (SNS) program, which leverages personal connections in social networks, to reach people with undiagnosed HIV infection for HIV testing. We targeted young black men who have sex with men (MSM) at 3 agencies in Memphis and Nashville, Tennessee, during 2013-2016. Methods: Specialists at the 3 agencies identified MSM with and without diagnosed HIV infection (ie, recruiters) who could recruit members from their social networks for HIV testing (ie, network associates). Both recruiters and network associates received OraQuick rapid and confirmatory HIV tests. We used χ2 and Fisher exact tests to assess differences in demographic characteristics, HIV testing, and care engagement status by agency. Results: Of 1752 people who were tested for HIV in the SNS program, 158 (9.0%) tested positive; of these, 80 (50.6%) were newly diagnosed with HIV. Forty-seven of the 78 (60.3%) people who were previously diagnosed with HIV were not in care in the previous 12 months; of these, 27 (57.4%) were reengaged in medical care. Of 80 people newly diagnosed with HIV, 44 (55.0%) were linked to care. Conclusions: The SNS program ascertained HIV status among a high-risk population in a heavily burdened region. Further program evaluation is needed to understand how to improve linkage to care among people with newly diagnosed HIV.

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