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Using HIV surveillance registry data to re-link persons to care: the RSVP Project in San Francisco.

Buchacz K, Chen MJ, Parisi MK, Yoshida-Cervantes M, Antunez E, Delgado V, Moss NJ, Scheer S - PLoS ONE (2015)

Bottom Line: Using SFDPH eHARS data as of 4/20/2012 (index date), we selected HIV-infected adults who were alive, had no reported VL or CD4 cell count results in the past nine months (proxy for "out-of-care") and a VL >200 copies/mL drawn nine to 15 months earlier.Matching to updated surveillance data revealed that a substantial minority did not disengage from care and that most re-engaged in HIV care.Verifying persons' HIV care status with medical providers and improving timeliness of transfer and cross-jurisdictional sharing of HIV laboratory data may aid future efforts.

View Article: PubMed Central - PubMed

Affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

ABSTRACT

Background: Persons with unsuppressed HIV viral load (VL) who disengage from care may experience poor clinical outcomes and potentially transmit HIV. We assessed the feasibility and yield of using the San Francisco Department of Public Health (SFDPH) enhanced HIV surveillance system (eHARS) to identify and re-engage such persons in care.

Methods: Using SFDPH eHARS data as of 4/20/2012 (index date), we selected HIV-infected adults who were alive, had no reported VL or CD4 cell count results in the past nine months (proxy for "out-of-care") and a VL >200 copies/mL drawn nine to 15 months earlier. We prioritized cases residing locally for investigation, and used information from eHARS and medical and public health databases to contact them for interview and referral to the SFDPH linkage services (LINCS). Twelve months later, we matched-back to eHARS data to assess how HIV laboratory reporting delays affected original eligibility, and if persons had any HIV laboratory results performed and reported within 12 months after index date ('new labs').

Results: Among 434 eligible persons, 282 were prioritized for investigation, of whom 75 (27%) were interviewed, 79 (28%) could not be located, and 48 (17%) were located out of the area. Among the interviewed, 54 (72%) persons accepted referral to LINCS. Upon match-back to eHARS data, 324 (75%) in total were confirmed as eligible, including 221 (78%) of the investigated; most had new labs.

Conclusions: Among the investigated persons presumed out-of-care, we interviewed and offered LINCS referral to about one-quarter, demonstrating the feasibility but limited yield of our project. Matching to updated surveillance data revealed that a substantial minority did not disengage from care and that most re-engaged in HIV care. Verifying persons' HIV care status with medical providers and improving timeliness of transfer and cross-jurisdictional sharing of HIV laboratory data may aid future efforts.

No MeSH data available.


RSVP Project Implementation Flowchart.
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pone.0118923.g002: RSVP Project Implementation Flowchart.

Mentions: Based on review of address and available provider information in eHARS, 152 (35%) of 434 RSVP project-eligible persons were excluded from further investigation: 113 living outside of GBA, and 39 who had their qualifying HIV VL test ordered by a provider outside of GBA (Fig. 2). The remaining 282 cases selected for investigation were similar to the 434 persons eligible for the RSVP project with respect to most socio-demographic and clinical variables (Table 1). A similar distribution of provider types ordering the qualifying HIV VL (data not shown) was also observed, with the exception that fewer (16%) had an unknown source. Only three providers responded to SFDPH’s informational letter and asked to review the list of patients identified for RSVP project from their clinic site; none recommended that SFDPH remove any patients from consideration for RSVP project.


Using HIV surveillance registry data to re-link persons to care: the RSVP Project in San Francisco.

Buchacz K, Chen MJ, Parisi MK, Yoshida-Cervantes M, Antunez E, Delgado V, Moss NJ, Scheer S - PLoS ONE (2015)

RSVP Project Implementation Flowchart.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352048&req=5

pone.0118923.g002: RSVP Project Implementation Flowchart.
Mentions: Based on review of address and available provider information in eHARS, 152 (35%) of 434 RSVP project-eligible persons were excluded from further investigation: 113 living outside of GBA, and 39 who had their qualifying HIV VL test ordered by a provider outside of GBA (Fig. 2). The remaining 282 cases selected for investigation were similar to the 434 persons eligible for the RSVP project with respect to most socio-demographic and clinical variables (Table 1). A similar distribution of provider types ordering the qualifying HIV VL (data not shown) was also observed, with the exception that fewer (16%) had an unknown source. Only three providers responded to SFDPH’s informational letter and asked to review the list of patients identified for RSVP project from their clinic site; none recommended that SFDPH remove any patients from consideration for RSVP project.

Bottom Line: Using SFDPH eHARS data as of 4/20/2012 (index date), we selected HIV-infected adults who were alive, had no reported VL or CD4 cell count results in the past nine months (proxy for "out-of-care") and a VL >200 copies/mL drawn nine to 15 months earlier.Matching to updated surveillance data revealed that a substantial minority did not disengage from care and that most re-engaged in HIV care.Verifying persons' HIV care status with medical providers and improving timeliness of transfer and cross-jurisdictional sharing of HIV laboratory data may aid future efforts.

View Article: PubMed Central - PubMed

Affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

ABSTRACT

Background: Persons with unsuppressed HIV viral load (VL) who disengage from care may experience poor clinical outcomes and potentially transmit HIV. We assessed the feasibility and yield of using the San Francisco Department of Public Health (SFDPH) enhanced HIV surveillance system (eHARS) to identify and re-engage such persons in care.

Methods: Using SFDPH eHARS data as of 4/20/2012 (index date), we selected HIV-infected adults who were alive, had no reported VL or CD4 cell count results in the past nine months (proxy for "out-of-care") and a VL >200 copies/mL drawn nine to 15 months earlier. We prioritized cases residing locally for investigation, and used information from eHARS and medical and public health databases to contact them for interview and referral to the SFDPH linkage services (LINCS). Twelve months later, we matched-back to eHARS data to assess how HIV laboratory reporting delays affected original eligibility, and if persons had any HIV laboratory results performed and reported within 12 months after index date ('new labs').

Results: Among 434 eligible persons, 282 were prioritized for investigation, of whom 75 (27%) were interviewed, 79 (28%) could not be located, and 48 (17%) were located out of the area. Among the interviewed, 54 (72%) persons accepted referral to LINCS. Upon match-back to eHARS data, 324 (75%) in total were confirmed as eligible, including 221 (78%) of the investigated; most had new labs.

Conclusions: Among the investigated persons presumed out-of-care, we interviewed and offered LINCS referral to about one-quarter, demonstrating the feasibility but limited yield of our project. Matching to updated surveillance data revealed that a substantial minority did not disengage from care and that most re-engaged in HIV care. Verifying persons' HIV care status with medical providers and improving timeliness of transfer and cross-jurisdictional sharing of HIV laboratory data may aid future efforts.

No MeSH data available.