267151 A higher standard of care for the most vulnerable: Examining how behavioral, social, medical, and structural factors influence linkage to care among newly diagnosed HIV positive adults

Monday, October 29, 2012

Tyler Alvare', BA , Department of Infectious Disease/HIV Medicine, Drexel College of Medicine, Philadelphia, OR
Cymara Tolbert, MPH , Department of Infectious Disease/HIV Medicine, Drexel College of Medicine, Philadelphia, PA
Erika Aaron, MSN, CRNP , Department of Infectious Disease/HIV Medicine, Drexel College of Medicine, Philadelphia, PA
Background: Despite great strides in development and availability of antiretroviral therapy, over 30% of individuals with HIV do not enter into HIV treatment. Linking newly diagnosed persons continues to remain a challenge. The aim of the study is to investigate the effects of socioeconomic, biomedical, and structural factors on patient's linkage to care after HIV diagnosis and to utilize these findings to devise more successful interventions. Methods: A cross-sectional, retrospective study was conducted using medical records for 94 patients diagnosed between May 2007 and November 2011. All subjects were identified at one major urban emergency department and three medical clinics located in areas of high HIV/AIDs prevalence. Twenty socioeconomic and biomedical indicators were examined in bivariate analysis for association with positive patients receiving treatment. Results: Medical records for 89 patients were determined to be eligible. We found that mental illness (p < 0.04), past behavior in health care environments (p < 0.001), drug abuse (p < 0.001), unemployment (p < 0.01), and homelessness predicted patient failure to link to care. Conclusion: These findings suggest that in order to improve successful linkage to care for newly diagnosed HIV patients, interventions must be adequately broad to address the complex social and structural challenges facing HIV positive populations.

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

Learning Objectives:
1.)Learners will demonstrate a better knowledge of the challenges that are involved in linking newly diagnosed individuals to care. 2.) Learners will be able to identify and devise successful broad based interventions to address complex challenges facing vulnerable populations.

Keywords: HIV/AIDS, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been principle investigator in several privately funded studies of the social impact of HIV on vulnerable populations. I was instrumental in designing this study, gathering data, reviewing relevant literature, and interpreting our findings within a broader public health framework.
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.