Logo image
Back
Predictors of Linkage to Care for Newly Diagnosed HIV-Positive Adults
Journal article   Open access   Peer reviewed

Predictors of Linkage to Care for Newly Diagnosed HIV-Positive Adults

Erika Aaron, Tyler Alvare, Ed J Gracely, Ralph Riviello and Amy Althoff
The western journal of emergency medicine, v 16(4), pp 535-542
Jul 2015
DOI: https://doi.org/10.5811/westjem.2015.4.25345
PMID: 26265965
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.5811/westjem.2015.4.25345View
Published, Version of Record (VoR) Open

Abstract

Emergency Service, Hospital Delivery of Health Care - organization & administration HIV Infections - epidemiology Humans Middle Aged Patient Participation Male Ambulatory Care Antiretroviral Therapy, Highly Active Young Adult Adolescent Adult Female HIV Infections - drug therapy Aged Patient Compliance Philadelphia Cohort Studies
Linkage to care following a human immunodeficiency virus (HIV) diagnosis is critical. In the U.S. only 69% of patients are successfully linked to care, which results in delayed receipt of antiretroviral therapy leading to immune system dysfunction and risk of transmission to others. We evaluated predictors of failure to link to care at a large urban healthcare center in Philadelphia in order to identify potential intervention targets. We conducted a cohort study between May 2007 and November 2011 at hospital-affiliated outpatient clinics, emergency departments (EDs), and inpatient units. Of 87 patients with a new HIV diagnosis, 63 (72%) were linked to care: 23 (96%) from the outpatient setting and 40 (63%) from the hospital setting (ED or inpatient) (p<0.01). Those who were tested in the hospital-based settings were more likely to be black (p=0.01), homeless (p=0.03), and use alcohol or drugs (p=0.03) than those tested in the outpatient clinics. Patients tested in the ED or inpatient units had a 10.9 fold (p=0.03) higher odds of failure to link compared to those diagnosed in an outpatient clinic. When testing site was controlled, unemployment (OR 12.2;p<0.01) and substance use (OR 6.4;p<0.01) were associated with failure to link. Our findings demonstrate the comparative success of linkage to care in outpatient medical clinics versus hospital-based settings. This study both reinforces the importance of routine opt-out HIV testing in outpatient practices, and demonstrates the need to better understand barriers to linkage.

Metrics

19 Record Views
14 citations in Web of Science
15 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Emergency Medicine
Logo image