222384 Implementing a Rapid HIV Testing/Linkage to Care Project Among Homeless Individuals in Los Angeles County: A Collaborative Effort between Federal, County, and City Government

Wednesday, November 10, 2010

Henry Anaya, PhD , Health Services Research and Development, US Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Los Angeles, CA
Herschel Knapp, PhD, MSSW , Quality Enhancement Research Initiative for HIV and Hepatitis (QUERI-HIV/HEP), US Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Los Angeles, CA
Magdalena Esquivel, BA , Department of Public Health, Office of AIDS Programs and Policy, County of Los Angeles, Los Angeles, CA
Sophia Rumanes, MPH , Department of Public Health, Office of AIDS Programs and Policy, County of Los Angeles, Los Angeles, CA
Michael Fletcher, MPH , Quality Enhancement Research Initiative for HIV and Hepatitis (QUERI-HIV/HEP), US Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Los Angeles, CA
Jaimi Butler, MA , Quality Enhancement Research Initiative for HIV and Hepatitis (QUERI-HIV/HEP), US Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Los Angeles, CA
Boyd Crough, RN, BSN, PHN , Department of Public Health, Office of AIDS Programs and Policy, County of Los Angeles, Los Angeles, CA
Stephen Simon, JD , AIDS Coordinator's Office, City of Los Angeles, Los Angeles, CA
BACKGROUND The homeless population, though vulnerable to HIV infection, traditionally lacks access to HIV testing diagnostics and linkage to care (LOC). This project, an ongoing collaborative effort involving Gilead Sciences, the US Department of Veterans Affairs (VA); County of Los Angeles, Department of Public Health, Office of AIDS Programs and Policy; and City of Los Angeles AIDS Coordinator's Office, is evaluating barriers and facilitators to: providing HIV rapid testing to homeless shelter clients; linking HIV-positive individuals to care through the VA or Los Angeles County Department of Health Services, depending on veteran status.

METHODS HIV oral rapid tests are offered by HIV counselors. In cases with (preliminary) positive test findings, confirmatory test and clinic appointment is arranged, and taxi voucher is provided. Summary sheets are kept including tests conducted and client's veteran status. Data analysis is ongoing to review performance.

RESULTS A year of data indicates significant progress in testing 552 clients tested (28 veterans), 5 preliminary positives (4 confirmed positive; 1 did not receive confirmation). LOC confirmed for 3; county affirms the 4th client's LOC pending proper support documentation. Challenges included development of confirmatory test procedures, gap between confirmation and LOC, and LOC follow-up.

CONCLUSION This collaboration between governmental agencies has been successful, and can be used as a model for future collaborative efforts of this type. Efforts are ongoing to better track clients using a new linkage to care model. We hope that this new model of linking immediately upon preliminary reading will expedite LOC.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Explain the issues associated with a multi-agency collaborative effort regarding implementation of HIV rapid testing for homeless individuals in shelter settings in Los Angeles County.

Keywords: HIV/AIDS, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the primary research associate and project coordinator on this project as well as other related rapid HIV testing projects.
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.