Online Program

317884
A Comparative Study of the Adolescent Initiative Multidisciplinary Team HIV Cascade of Care and the Philadelphia Department of Public Health Youth HIV Cascade of Care


Sunday, November 1, 2015

Rosemary Thomas, MPH, CHES, Department of Pediatrics, Division of Adolescent Medicine, Adolescent Initiative, The Children's Hospital of Philadelphia, Philadelphia, PA
Purpose: To determine clinical outcomes for HIV+ 18-24 year old patients of the AI Clinic using the HIV Cascade. To compare these outcomes to the general Philadelphia population of HIV+18-24 year olds using PDPH Data and to determine trends over time within the AI Clinic.

Methods: Data routinely collected in the Ryan White CAREWare database was used in aggregate to construct the AI Cascade. Encrypted data was collected for the years 2009-2010 and 2012-2013. Data includes all new HIV diagnoses for the years 2009 and 2012, dates of medical visits for each new diagnosis for one calendar year after diagnosis, prescription of Highly Active Anti-Retroviral Treatment (HAART) during that year and viral load(s) during that year.

Comparisons were made using percentages for each category between the 2009 AI Cascade and the 2010 PDPH Cascade and between the 2009 and 2012 AI Cascade. 

Results: The AI Cascade is dissimilar to national models.  Between 2009 and 2012, the AI clinic improved slightly across categories except prescribed HAART. This difference cannot be explained without further research.  The general population of HIV+ 18-24 year olds in Philadelphia is performing marginally better than those in the AI cascade. This may be due to differences in data collection and definition.

Conclusions: Despite using best practices, the AI clinic has outcomes lower than the general Philadelphia population of HIV+ 18-24 year olds. Areas for further research include elucidating specific characteristics of each patient population to further explain differences in outcomes and design measures to improve care.

Learning Areas:

Clinical medicine applied in public health
Epidemiology
Other professions or practice related to public health

Learning Objectives:
Describe the HIV Cascade and it's applications in evaluating clinical care. Discuss the link between HIV Care and HIV prevention. Discuss the specific issues relating adolescents living with HIV and the HIV Cascade of Care. Identify the limitations of the HIV Cascade of Care as a tool for evaluation. Discuss best practices for engaging adolescents in HIV Care.

Keyword(s): Adolescents, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 7 years of experience working in HIV Care and prevention. I was the co-investigator on "A Comparative Study of the Adolescent Initiative Multidisciplinary Team HIV Cascade of Care and the Philadelphia Department of Public Health Youth HIV Cascade of Care" and have working as a research assistant on two other studies focusing on youth and HIV.
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.

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