Strategies for promoting linkages to care among newly-diagnosed HIV-positive members of racial and ethnic minority communities who receive HIV testing in hospital emergency and public health department settings

The purpose of this “best practices” study is to identify and examine successful models used by hospital emergency departments, health department clinics, and other providers for testing, linking, and engaging newly diagnosed HIV-positive racial and ethnic minorities into primary care. Previous research indicates that many patients visit health care providers multiple times before they receive a recommendation for an HIV test, even among those with conditions or characteristics that are suggestive of risk for HIV infection. In response, CDC recommended that counseling and risk assessment before HIV testing be discontinued and that post-test counseling and rapid linkage to care for HIV-positive individuals be emphasized to encourage patients to learn the results of their HIV tests and ensure access to care for people newly diagnosed with HIV. Our formative evaluation is based on qualitative information collected from a range of stakeholders representing different perspectives on HIV testing and linkages to care. The primary data collection activities for this study include (1) a review of the literature and other background material; (2) consultation with key experts knowledgeable about testing and linkages to care; and (3) case study discussions and site visits with individuals and organizations in five jurisdictions who are working on the front lines to establish linkages between HIV testing and care for minority populations. The study (1) identifies barriers to creating linkages between HIV testing and treatment services and (2) identifies critical components of successful testing and linkage initiatives in different health care settings serving minority racial and ethnic populations.