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Abstract #147176

Jason A. Craw, MPH and Lytt I. Gardner, PhD. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-45, Atlanta, GA 30333, (404) 639-6395, emf4@cdc.gov

Background: Nearly 40% of persons testing positive for HIV delay entering primary care for a year or more. The Antiretroviral Treatment Access Study (ARTAS-II) utilized a brief (5 contacts/90 days) strengths-based case management model to facilitate entry into care of recently diagnosed HIV-infected persons. The primary objective was to achieve 75% linkage to care within six months of enrollment.

Methods: ARTAS-II was conducted in health departments and community-based organizations (CBOs) in the U.S. from 2005-2007. 646 participants recently diagnosed with HIV and not in care were enrolled. 423 have completed baseline and 6-month interviews. A total estimated percentage of care-linkage at six months was calculated using self-interview, medical record data, and reports from the participant's case manager.

Results: Participants were predominantly male (72.2%), black non-Hispanic (70.0%), annual household income £$10,000 (61.9%), median age=35. 86.3% (365/423) of participants completing the 6-month interview reported visiting an HIV care provider since baseline interview. Among those not interviewed at follow-up but who had medical record data available, 85.2% (46/54) had at least one documented HIV-related care visit. For the remaining 169 participants, case manager documentation confirmed that 52.7% (89/169) linked to care. The total estimated percentage of care-linkage within the first six months is 77.4% (500/646). Multivariate analysis revealed that feeling well/not having symptoms was significantly associated with not linking to care (OR_adj=12.9; p<.0001).

Conclusions: Brief case management conducted at health departments and CBOs by existing staff is an effective tool to increase the number of recently diagnosed persons quickly entering HIV primary care.

Learning Objectives:

• Discuss the public health significance of HIV-infected persons delaying entry into care.
• Describe 2 features of ARTAS strengths-based case management.
• List at least 2 factors found to be associated with clients who do not link to HIV primary care.

Keywords: HIV/AIDS, Medical Care

Related Web page: www.cdc.gov/hiv/topics/prev_prog/AHP/resources/factsheets/ARTASSII.htm

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.