HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.

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Use of HIV Case Surveillance System to Design and Evaluate Site-Randomized Interventions in an HIV Prevention Study: HPTN 065

The Open AIDS Journal ◽

10.2174/1874613601206010122 ◽

2012 ◽

Vol 6 (1) ◽

pp. 122-130 ◽

Cited By ~ 15

Author(s):

Deborah J Donnell ◽

H Irene Hall ◽

Theresa Gamble ◽

Geetha Beauchamp ◽

Angelique B Griffin ◽

...

Keyword(s):

Hiv Prevention ◽

Surveillance System ◽

Viral Suppression ◽

Laboratory Data ◽

Linkage To Care ◽

Baseline Data ◽

Surveillance Data ◽

Hiv Care ◽

Hiv Surveillance ◽

Hiv Test

Introduction:Modeling studies suggest intensified HIV testing, linkage-to-care and antiretroviral treatment to achieve viral suppression may reduce HIV transmission and lead to control of the epidemic. To study implementation of strategy, population-level data are needed to monitor outcomes of these interventions. US HIV surveillance systems are a potential source of these data.Methods:HPTN065 (TLC-Plus) Study is evaluating the feasibility of a test, linkage-to-care, and treat strategy for HIV prevention in two intervention communities - the Bronx, NY, and Washington, DC. Routinely collected laboratory data on diagnosed HIV cases in the national HIV surveillance system were used to select and randomize sites, and will be used to assess trial outcomes.Results:To inform study randomization, baseline data on site-aggregated study outcomes was provided from HIV surveillance data by New York City and Washington D.C. Departments of Health. The median site rate of linkage-to-care for newly diagnosed cases was 69% (IQR 50%-86%) in the Bronx and 54% (IQR 33%-71%) in Washington, D.C. In participating HIV care sites, the median site percent of patients with viral suppression (<400 copies/mL) was 57% (IQR 53%-61%) in the Bronx and 64% (IQR 55%-72%) in Washington, D.C.Conclusions:In a novel use of site-aggregated surveillance data, baseline data was used to design and evaluate site randomized studies for both HIV test and HIV care sites. Surveillance data have the potential to inform and monitor sitelevel health outcomes in HIV-infected patients.

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HIV Infection Care and Viral Suppression Among People Who Inject Drugs, 28 U.S. Jurisdictions, 2012-2013

The Open AIDS Journal ◽

10.2174/1874613601610010127 ◽

2016 ◽

Vol 10 (1) ◽

pp. 127-135 ◽

Cited By ~ 11

Author(s):

Debra L. Karch ◽

Kristen Mahle Gray ◽

Jing Shi ◽

H. Irene Hall

Keyword(s):

Young People ◽

Hiv Infection ◽

Viral Suppression ◽

People Who Inject Drugs ◽

Early Stage ◽

Linkage To Care ◽

Retention In Care ◽

Infected People ◽

Hiv Surveillance ◽

Stage Infection

Objectives: Assess outcomes along the care continuum for HIV-infected people who inject drugs (PWID), by type of facility and stage of infection at diagnosis. Methods: Data reported by 28 jurisdictions to the National HIV Surveillance System by December 2014 were used to identify PWID aged ≥13 years, diagnosed with HIV infection before December 31, 2013. Analyses used the CDC definition of linkage to care (LTC), retention in care (RIC), and viral suppression (VS), and are stratified by age, sex, race/ethnicity, and type of facility and stage of HIV infection at diagnosis. Results: Of 1,409 PWID diagnosed with HIV in 2013, 1,116 (79.2%) were LTC with the lowest percentages among males (78.4%); blacks (77.5%) ages 13-24 years (69.0%); those diagnosed in early stage infection (71.6%); and at screening, diagnostic, or referral agencies (60.0%). Of 80,958 PWID living with HIV in 2012, 40,234 (49.7%) were RIC and 34,665 (42.8%) achieved VS. The lowest percentages for RIC and VS were among males (47.1% and 41.3% respectively); those diagnosed with late stage disease (47.1% and 42.4%); and young people. Whites had the lowest RIC (47.0%) while blacks had the lowest VS (41.1%). Conclusion: Enhanced LTC activities are needed for PWID diagnosed at screening, diagnostic or referral agencies versus those diagnosed at inpatient or outpatient settings, especially among young people and blacks diagnosed in early stage infection. Less than half of PWID are retained in care or reach viral suppression indicating the need for continued engagement and return to care activities over the long term.

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The Interconnected Dynamics of Partnership and HIV: A Qualitative Exploration of Experiences from Heterosexual Individuals Newly Diagnosed with HIV

10.21203/rs.3.rs-1182257/v1 ◽

2021 ◽

Author(s):

maira sohail ◽

Emily B. Levitan ◽

Dustin M. Long ◽

Michael J. Mugavero ◽

Akinyemi I. Ojesina ◽

...

Keyword(s):

African American ◽

Retention In Care ◽

The United States ◽

Hiv Care ◽

Newly Diagnosed ◽

Hiv Education ◽

Heterosexual Couples ◽

Hiv Diagnosis ◽

Care Outcomes

Abstract Background Recent studies have focused on the role of intimate partnership on HIV care outcomes among men who have sex with men in the United States (US) and heterosexual couples in some African studies, leaving a gap in the recent US-based literature on the role of having an intimate partner on HIV care outcomes among heterosexual couples. Therefore, the objective of this study was to explore the lived experiences of heterosexual individuals newly diagnosed with HIV regarding the role of partnership on HIV care. MethodsThis phenomenological study conducted one time, virtual, in-depth interviews with six heterosexual individuals newly diagnosed with HIV ≥2017. The data analysis followed Moustakas approach to identify themes and sub-themes. ResultsThe participants were predominantly female and African American with median age of 46 years. Four themes identifying association between partnership and HIV care included role of HIV on partnership, under which impact of HIV on partnership and presumed reaction if partner was diagnosed with HIV were identified; Impact of partnership on HIV identified perception on dealing with HIV diagnosis without a partner and role of family vs. partner in HIV care as sub-themes; forms of support from partner in HIV care identified partner support around the time of HIV diagnosis and linkage to HIV care and around retention in care; and perceptions on the types of partner-based clinic services, which identified areas such as couples therapy, assistance with partner communication on sensitive topics such as HIV disclosure, and HIV education of the partner. The findings showed that partnership played a vital role in HIV care among partnered individuals; and the importance of a partner in HIV care was acknowledged by unpartnered participants. Various support practices by partners around HIV diagnosis and retention in care were identified. Quality of partnership played a bigger role in HIV care than presence of partnership. ConclusionThe importance of partner-based interventions in improving the HIV care of the person with HIV (PWH) was acknowledged. While demonstrating views of mainly African American women living with HIV in the Southern US, findings may be transferrable to other heterosexual PWH in other locales.

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Preliminary results from the new HIV surveillance system in France

Eurosurveillance ◽

10.2807/esm.09.10.00481-en ◽

2004 ◽

Vol 9 (10) ◽

pp. 7-8 ◽

Cited By ~ 19

Author(s):

F Lot ◽

C Semaille ◽

F Cazein ◽

F Barin ◽

R Pinget ◽

...

Keyword(s):

Hiv Infection ◽

Surveillance System ◽

Hiv Infections ◽

Local Health ◽

Notification System ◽

Hiv Surveillance ◽

Health Authorities ◽

First Results ◽

Local Health Authorities ◽

Virological Surveillance

In addition to AIDS surveillance, data on HIV infection are necessary to better follow the dynamics of the epidemic. We report the first results of France's mandatory anonymous HIV notification system, which is linked to a virological surveillance of recent HIV infections and of circulating HIV types, groups and subtypes. HIV notifications are initiated by microbiologists who create an anonymous code of patient's identity. Clinicians complete the notification form with epidemiological and clinical data. Notifications are sent to the local health authorities and passed to the Institut de Veille Sanitaire (InVS).

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Trends in Care and Treatment for Persons Aged ≥13 Years with HIV Infection 17 U.S. Jurisdictions, 2012-2015

The Open AIDS Journal ◽

10.2174/1874613601812010090 ◽

2018 ◽

Vol 12 (1) ◽

pp. 90-105 ◽

Cited By ~ 1

Author(s):

Debra L. Karch ◽

Xueyuan Dong ◽

Jing Shi ◽

H. I. Hall

Keyword(s):

Hiv Infection ◽

Viral Suppression ◽

Linkage To Care ◽

Risk Groups ◽

Sexual Contact ◽

Hiv Diagnosis ◽

Annual Percent Change ◽

Hiv Surveillance ◽

High Risk Populations ◽

National Trends

Background: Care and viral suppression national goals for HIV infection are not being met for many at-risk groups. Assessment of the trends in national outcomes for linkage to care, receipt of care, and viral suppression among these groups is necessary to reduce transmission. Methods: Data reported to the National HIV Surveillance System by December 2016 were used to identify cases of HIV infection among persons aged 13 years and older in one of 17 identified jurisdictions with complete laboratory reporting. We estimated national trends in HIV-related linkage to care, receipt of care and viral suppression using estimated annual percent change from 2012-2015 for various characteristics of interest, overall and stratified by sex and race/ethnicity. Results: Overall, trends in linkage to and receipt of care and viral suppression increased from 2012-2015. Generally, linkage to and receipt of care increased among young black and Hispanic/Latino males, those with infection attributed to male-to-male sexual contact, and those not in stage 3 [AIDS] at HIV diagnosis. All sub-groups showed improvement in viral suppression. Within years, there remains a substantial disparity in receipt of care and viral suppression among racial/ethnic groups. Conclusion: While trends are encouraging, scientifically proven prevention programs targeted to high-risk populations are the foundation for stopping transmission of HIV infection. Frequent testing to support early diagnosis and prompt linkage to medical care, particularly among young men who have male to male sexual contact, black and Hispanic/Latino populations, are key to reducing transmission at all stages of disease.

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A Matter of Perspective: Comparison of the Characteristics of Persons with HIV Infection in the United States from the HIV Outpatient Study, Medical Monitoring Project, and National HIV Surveillance System

The Open AIDS Journal ◽

10.2174/1874613601509010123 ◽

2015 ◽

Vol 9 (1) ◽

pp. 123-133 ◽

Cited By ~ 13

Author(s):

Kate Buchacz ◽

Emma L. Frazier ◽

H. Irene Hall ◽

Rachel Hart ◽

Ping Huang ◽

...

Keyword(s):

United States ◽

Hiv Infection ◽

Surveillance System ◽

The United States ◽

Hiv Care ◽

Medical Monitoring ◽

Hiv Surveillance ◽

The Us ◽

Medical Monitoring Project ◽

Outpatient Study

Comparative analyses of the characteristics of persons living with HIV infection (PLWH) in the United States (US) captured in surveillance and other observational databases are few. To explore potential joint data use to guide HIV treatment and prevention in the US, we examined three CDC-funded data sources in 2012: the HIV Outpatient Study (HOPS), a multisite longitudinal cohort; the Medical Monitoring Project (MMP), a probability sample of PLWH receiving medical care; and the National HIV Surveillance System (NHSS), a surveillance system of all PLWH. Overall, data from 1,697 HOPS, 4,901 MMP, and 865,102 NHSS PLWH were analyzed. Compared with the MMP population, HOPS participants were more likely to be older, non-Hispanic/Latino white, not using injection drugs, insured, diagnosed with HIV before 2009, prescribed antiretroviral therapy, and to have most recent CD4+ T-lymphocyte cell count ≥500 cells/mm3 and most recent viral load test<2 00 copies/mL. The MMP population was demographically similar to all PLWH in NHSS, except it tended to be slightly older, HIV diagnosed more recently, and to have AIDS. Our comparative results provide an essential first step for combined epidemiologic data analyses to inform HIV care and prevention for PLWH in the US.

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Predictors of Linkage to and Retention in HIV Care Following Release from Connecticut Jails and Prisons

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.092 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S38-S38

Author(s):

Kelsey B Loeliger ◽

Frederick L Altice ◽

Mayur M Desai ◽

Maria M Ciarleglio ◽

Colleen Gallagher ◽

...

Keyword(s):

Case Management ◽

Viral Suppression ◽

Linkage To Care ◽

Retention In Care ◽

Hiv Treatment ◽

Hiv Care ◽

People Living With Hiv ◽

Hiv Surveillance ◽

Targeted Interventions ◽

Retention In Hiv Care

Abstract Background One in six people living with HIV (PLH) in the USA transition through prison or jail annually. During incarceration, people may engage in HIV care, but transition to the community remains challenging. Linkage to care (LTC) post-release and retention in care (RIC) are necessary to optimizing HIV outcomes, but have been incompletely assessed in prior observational studies. Methods We created a retrospective cohort of all PLH released from a Connecticut jail or prison (2007–2014) by linking Department of Correction demographic, pharmacy, and custody databases with Department of Public Health HIV surveillance monitoring and case management data. We assessed time to LTC, defined as time from release to first community HIV-1 RNA test, and viral suppression status at time of linkage. We used generalized estimating equations to identify correlates of LTC within 14 or 30 days after release. We also described RIC over three years following an initial release, comparing recidivists to non-recidivists. Results Among 3,302 incarceration periods from 1,350 unique PLH, 21% and 34% had LTC within 14 and 30 days, respectively, of which >25% had detectable viremia at time of linkage. Independent correlates of LTC at 14 days included incarceration periods >30 days (adjusted odds ratio [AOR] = 1.6; P < 0.001), higher medical comorbidity (AOR = 1.8; P < 0.001), antiretrovirals prescribed before release (AOR = 1.5; P = 0.001), transitional case management (AOR = 1.5; P < 0.001), re-incarceration (AOR = 0.7; P = 0.002) and conditional release (AOR = 0.6; P < 0.001). The 30-day model additionally included psychiatric comorbidity (AOR = 1.3; P = 0.016) and release on bond (AOR = 0.7; P = 0.033). Among 1,094 PLH eligible for 3-year follow-up, RIC after release declined over 1 year (67%), 2 years (51%) and 3 years (42%). Recidivists were more likely than nonrecidivists to have RIC but, among those retained, were less likely to be virally suppressed (Figure 1). Conclusion For incarcerated PLH, both LTC and RIC as well as viral suppression are suboptimal after release. PLH who receive case management are more likely to have timely LTC. Targeted interventions and integrated programming aligning health and criminal justice goals may improve post-release HIV treatment outcomes. Disclosures All authors: No reported disclosures.

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1652. Equivalent HIV Outcomes for Persons with HIV after Re-engagement in HIV Care with Prior or New Provider

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1516 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S604-S604

Author(s):

Chi-Chi N Udeagu ◽

Sharmila Shah ◽

Sarah Braunstein

Keyword(s):

New York ◽

Viral Suppression ◽

Retention In Care ◽

Health Department ◽

Hiv Care ◽

Heterosexual Transmission ◽

Hiv Surveillance ◽

History Of ◽

Male Sex ◽

Engagement In Hiv Care

Abstract Background New York City (NYC) health department staff assist people with HIV (PWH) deemed out of care (OOC) per NYC HIV Surveillance Registry to re-engage in HIV care with their last known treating provider/parent clinic or, if preferable/necessary (e.g., moved to a new neighborhood), a new NYC provider. We examined retention in care and viral suppression (VS) of PWH re-engaged in care in a group who agreed to return to care and were cared for by either their previous or a new provider. Methods We analyzed data from 2009 to 2015 on PWH who had ≥2 CD4 count or viral load (VL) test reports in the NYC HIV Registry who fell out of care and then re-engaged in care. We compared characteristics, timeliness and retention in care (≥2 CD4 or VL, ≥90 days apart) and VS (last VL ≤200 copies/mL) of PWH overall and also according to whether they returned to their last known vs. a new provider in year 2 post re-engagement in care. Results From 2009–2015, 882 persons were re-engaged in care by the health department. Most were diagnosed 5–10 (27%) or >10 (67%) years prior, and were OOC for 1–3 years (70%) or >3 years (20%). Most re-engaged PWH were male (63%), black (56%) or Hispanic (34%), US-born (79%), aged 30–49 (48%) or ≥50 (40%) years. Risk factors for HIV included heterosexual transmission (39%), male-sex-with-male (26%) or injection drug use (18%). Twenty-two percent had history of homelessness and 5% incarceration. Fifty-one percent and 49% re-engaged in care with their prior or a new provider, respectively. PWH re-engaged with prior providers vs. new providers had lower rates of prior or current homelessness (17% vs. 28%, P = 0.0001), PWH re-engaged to prior vs. new providers had their first lab reports and achieved VS earlier (1 vs. 2 months, and 4 vs. 5 months, respectively (both P < 0.05). Proportions of PWH re-engaged to prior or new providers and retained in care (92% vs. 91%, respectively) or with VS (73% vs. 75%, respectively) in year 2 did not differ. Conclusion Our results show that health department efforts to re-engage previously OOC-PWH in HIV care resulted in more than 70% achieving VS. Assignment to a new provider resulted in earlier VS but did not affect 2-year VS or care retention. PWH who re-engage in care can safely be given the choice between known or new providers. Disclosures All authors: No reported disclosures.

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Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009–2014

AIDS and Behavior ◽

10.1007/s10461-016-1656-7 ◽

2016 ◽

Vol 21 (9) ◽

pp. 2774-2783 ◽

Cited By ~ 82

Author(s):

Hollie Clark ◽

Aruna Surendera Babu ◽

Ellen Weiss Wiewel ◽

Jenevieve Opoku ◽

Nicole Crepaz

Keyword(s):

Hiv Infection ◽

Surveillance System ◽

Hiv Surveillance

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“Is a Bird in the Hand Worth 5 in the Bush?”: A Comparison of 3 Data-to-Care Referral Strategies on HIV Care Continuum Outcomes in San Francisco

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa369 ◽

2020 ◽

Vol 7 (9) ◽

Author(s):

Darpun D Sachdev ◽

Elise Mara ◽

Alison J Hughes ◽

Erin Antunez ◽

Robert Kohn ◽

...

Keyword(s):

San Francisco ◽

Health Care Providers ◽

Viral Suppression ◽

Hiv Care ◽

Care Providers ◽

Care Continuum ◽

Hiv Surveillance ◽

Relative Risks ◽

Linkage To Hiv Care ◽

Durable Viral Suppression

Abstract Background Health departments utilize HIV surveillance data to identify people with HIV (PWH) who need re-linkage to HIV care as part of an approach known as Data to Care (D2C.) The most accurate, effective, and efficient method of identifying PWH for re-linkage is unknown. Methods We evaluated referral and care continuum outcomes among PWH identified using 3 D2C referral strategies: health care providers, surveillance, and a combination list derived by matching an electronic medical record registry to HIV surveillance. PWH who were enrolled in the re-linkage intervention received short-term case management for up to 90 days. Relative risks and 95% confidence intervals were calculated to compare proportions of PWH retained and virally suppressed before and after re-linkage. Durable viral suppression was defined as having suppressed viral loads at all viral load measurements in the 12 months after re-linkage. Results After initial investigation, 233 (24%) of 954 referrals were located and enrolled in navigation. Although the numbers of surveillance and provider referrals were similar, 72% of enrolled PWH were identified by providers, 16% by surveillance, and 12% by combination list. Overall, retention and viral suppression improved, although relative increases in retention and viral suppression were only significant among individuals identified by surveillance or providers. Seventy percent of PWH who achieved viral suppression after the intervention remained durably virally suppressed. Conclusions PWH referred by providers were more likely to be located and enrolled in navigation than PWH identified by surveillance or combination lists. Overall, D2C re-linkage efforts improved retention, viral suppression, and durable viral suppression.

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