202196 An evaluation of an HIV linkage to care program: Baltimore's successes and challenges

Wednesday, November 11, 2009: 1:10 PM

Amanda E. Tanner, PhD, MPH , Department of Public Health Sciences, University of North Carolina - Charlotte, Charlotte, NC
Rafiq Miazad, MD , Bureau of STD/HIV Prevention, Baltimore City Health Department, Baltimore, MD
Sheridan Johnson, BA , Bureau of STD/HIV Prevention, Baltimore City Health Department, Baltimore, MD
Ravikiran Muvva, MPH, MPA , Bureau of STD/HIV Prevention, Baltimore City Health Department, Baltimore, MD
Jonathan Ellen, MD , Division of Pediatrics and Adolescent Medicine, Johns Hopkins University, Baltimore, MD
Background: If the benefits of expanded HIV testing programs are to be realized, individuals must be linked to care. While essential, few HIV care linkage programs have been integrated into standard testing programs. The Baltimore City Health Department (BCHD) has merged these efforts with successes and challenges.

Methodology: Between January-June 2007 the BCHD tested 11,692 individuals utilizing non-rapid HIV tests; 428 tested positive [70.3% men, 91.6% African American; 54.2% under 45 years]. Post-test counseling activity records were completed by disease intervention specialists for HIV positive individuals and entered into the national STD Management Information System. The possible outcomes were: 1) already in care, 2) linked to care, 3) not located, or 4) refused care.

Results: Of the HIV positive individuals 295 (68.9%) were already in care [32.0% through record search; 36.9% through field investigation]. Of the remaining 133 individuals, the program was able to link 19 (14.3%) into care while 88 (66.2%) were not locatable and only 5 (3.8%) refused care.

Conclusions: The results of the study suggest that BCHD is becoming increasingly skillful in linking new HIV positive individuals into care. However, the limited available resources are needlessly wasted in contacting individuals already in care highlighting the need for more accurate and efficient care data management. In addition, the inability to locate a sizable positive population may warrant the use of rapid testing methods. BCHD's success and lessons learned should be a model for other health department-academic partnerships in order to promote HIV prevention and conserve resources.

Learning Objectives:
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Demonstrate the HIV prevention benefits of expanded HIV testing and care linkage programs. 2. Identify factors that challenge and facilitate health departmentsí ability to test and successfully link HIV positive individuals to care services. 3. Convey the importance of resources for HIV surveillance, testing, and care linkage databases.

Keywords: Health Departments, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently doing a postdoctoral research fellowship at Johns Hopkins Bloomberg School of Public Health (PhD and MPH done at Indiana University)
Any relevant financial relationships? No

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.