142nd APHA Annual Meeting and Exposition

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Innovative Method for Identifying and Re-Engaging Lost HIV Clinic Patients: The Navigation Program

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 12:30 PM - 12:45 PM

Rhodri Dierst-Davies, MPH , Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Saloniki James, MA , Division of HIV & STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Amy Wohl, MPH, PhD , Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Audio (mp3) recording Recorded Presentation (mp4)
Issues: In an effort to implement a coordinated response to the local HIV/AIDS epidemic, the LA County PrEP and TLC+ for HIV Prevention(PATH) program includes a set of innovative, evidence-based interventions across the continuum of HIV prevention and care. An estimated 47% of HIV-infected persons in Los Angeles County(LAC) were retained in care in 2011. The Navigation Program was developed to identify, locate and re-engage lost patients. Enhanced public health investigative techniques to locate/contact patients include HIV/STD surveillance, clinic records and public databases. A modified ARTAS strength-based intervention promotes linkage to care.

Description: Eligible lost clinic patients included HIV-infected adults with either: a) no reported VL/CD4 measures in previous 12mo per HIV surveillance; b) no reported VL/CD4 in 7-12mo and most recent VL>200copies/ml; c) newly- diagnosed and not linked to care within 3mo; and d) recent incarceration with no regular provider.

Lessons Learned: Navigation Program pilot data for 499 lost clinic patients at four HIV clinics has determined that 43% were ineligible(in-care elsewhere, deceased, not LAC residents); 43% were unavailable or had invalid contact information and 12% were located and enrolled(n=47). The majority were Latino(68%), male(72%), and uninsured(51%).The most useful contact information came from HIV surveillance(39%) and clinic medical records(36%). An average of 7 appointments over 90 days was needed to link patients to care. A total of 98% of participants were linked to care.

Recommendations: HIV surveillance and clinic medical records provided the most useful contact information and the modified ARTAS intervention was effective at linking persons to care.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Evaluate the effectiveness of using multiple surveillance sources for identifying HIV infected persons who have fallen out of care. Compare different intervention strategies designed to re-engage HIV infected person who have fallen out of care.

Keyword(s): HIV/AIDS, HIV Interventions

Presenting author's disclosure statement:

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.

Back to: 4236.0: Engagement and Retention in HIV Care