142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

One size does not fit all: An assessment of HIV linkage, retention and re-engagement programs in Southern states

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 12:30 PM - 12:45 PM

Miriam Berger, MPH , Center for Health Policy and Inequalities Research, Duke University, Durham, NC
Kristen Sullivan, PhD, MSW, MA , Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC
Kathleen Perry , Duke University, Global Health Institute, Durham
Megan Ramaiya , Duke Global Health Institute, Durham, NC
Heather Parnell, MSW , Center for Health Policy and Inequalities Research, Duke University, Durham, NC
Evelyn Byrd Quinlivan, M.D. , Institute for Global Health and Infectious Diseases; UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill
Background: Linkage to and retention in consistent HIV care are goals of the National HIV/AIDS Strategy. Social determinants of health including stigma and poverty present barriers to reaching these goals in the South, where disproportionate HIV/AIDS incidence and case fatality rates are public health concerns. State health departments are uniquely positioned to identify patients in need of linkage/retention services, access client HIV data, and coordinate these services.

Methods: Telephone interviews utilizing a semi-structured interview guide were conducted with state health department representatives from the U.S. Census-defined Southern Region. The purpose was to explore the presence and structure of their state-run HIV care navigation programs.  Responses were summarized and compared across states.

Results: Fifteen of the 17 Southern Region states (88%) have currently participated in the study. Twelve states (80%) coordinated their HIV care navigation programs; six of these state health departments directly employed their navigators. In addition, overall strategies to link and retain patients, definitions of care engagement, and roles and training of navigators varied by state.  Similarities existed in retention-in-care challenges; the most commonly-cited systemic barriers included navigator responsibilities for vast geographic areas and data reporting issues. Patient barriers most frequently mentioned included stigma/fear of HIV disclosure, transportation, transience and perceived good health.

Conclusions: State health departments in the South utilize a variety of strategies to link, retain, and re-engage patients in HIV care.  Understanding the variety of linkage and retention efforts and their organizational oversight is important to identify approaches to address the HIV/AIDS burden in the South.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Identify the benefits of linkage to and retention in consistent HIV care. Describe the HIV/AIDS epidemiologic trends in the Southern Region of the United States. Compare the strategies and methods employed by states in the Southern Region of the United States to link, retain and re-engage patients in care.

Keyword(s): HIV/AIDS, Public Health Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked on multiple federally funded grants focusing on HIV prevention, and management of HIV care on an institutional level. I collected the majority of the primary data for this abstract and performed the initial analysis on the data collected.
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.