Project Engage: Snowball Sampling and Direct Recruitment of Out of Care HIV-Infected Persons
Description: A combination of snowball sampling and direct recruitment was used. Recruiters(seeds) were from HIV clinics/agencies. OOC persons(alters) were identified either through social networks, directly by clinic/agency staff, or flyers. OOC was defined as no care visits in >12mo; no care visits in 7-12mo and most recent VL>200copies/ml; newly-diagnosed and not linked to care within 3mo; or recently released from jail and no provider. OOC status was verified using LAC-HIV surveillance. Staff advocated for linkage and negotiated barriers.
Lessons Learned: To date, 24 OOC persons were enrolled via social networks(n=22) or direct recruitment(n=2). OOC were: African-Americans(46%), MSM(83%), the uninsured(67%), recently incarcerated(58%), homeless(75%) and individuals engaged in exchange sex(25%). On average, participants were OOC for 10mo; report a history of ART(67%); and had elevated VL pre-enrollment(mean=50,565copies/ml). It took an average of 12 days to link clients to care. Among patients enrolled, 18/24(75%) linked were to care, with 7/8(88%) retained in care at 6mo. Program acceptability was high.
Recommendations: A combination of snowball sampling and direct recruitment is feasible for engaging hard-to-reach, severely marginalized OOC HIV-infected persons in order to provide linkage support.
Learning Areas:Planning of health education strategies, interventions, and programs
Public health or related research
Compare the effectiveness of different recruitment techniques for identifying and re-engaging HIV infected person who have fallen out of care.
Keyword(s): HIV/AIDS, HIV Interventions
Qualified on the content I am responsible for because: I have multiple years of experience in the fields of HIV research and program evaluation. I have also performed program management for multiple federally funded research projects related to HIV prevention and health care delivery.
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.