Longitudinal outcomes of HIV- infected persons re-engaged in care using a community-based re-engagement approach

AIDS Care. 2020 Jan;32(1):76-82. doi: 10.1080/09540121.2019.1619662. Epub 2019 May 25.

Abstract

Re-engaging people living with HIV (PLWH) who are out of care (OOC) is of utmost importance to ending the HIV epidemic in the U.S. We used DC Department of Health (DCDOH) HIV surveillance data to determine whether re-engaging PLWH results in improved long-term clinical outcomes. PLWH identified as OOC for 6-12 months at both the clinic-level and using DCDOH data were targeted for re-engagement efforts through Recapture Blitz (RB). Uni- and bivariate analyses were conducted comparing engagement in care (EIC), CD4 counts, and viral suppression (VS) at 6, 12, and 18-months post-re-engagement between persons re-engaged through RB and those not re-engaged via RB. Of the 569 PLWH contacted; 57 were re-engaged through RB, 46 were not but may have reengaged on their own. Compared to those not re-engaged via RB, at 18-months of follow-up, more PLWH re-engaged through RB were EIC (71.9% vs. 56.5%) and VS (52.6% vs. 30.4%). Higher proportions of PLWH re-engaged through RB were virally suppressed at 6, 12, and 18-months (p = 0.0238, p = 0.0347, p = 0.0238, respectively). Combining surveillance and clinical data to identify persons OOC allowed for successful re-engagement and improved longer-term outcomes post-re-engagement, underscoring the importance of re-engagement efforts to improve rates of retention and viral suppression.

Keywords: HIV; engagement in care; linkage to care; surveillance; viral suppression.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • CD4 Lymphocyte Count
  • District of Columbia / epidemiology
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • HIV Infections / virology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Viral Load