2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

326618
Time to linkage to care among newly diagnosed MSM: The MSM Testing Initiative


Sunday, November 1, 2015

Chanza Baytop, MPH, DrPH, U.S. Health Division, Abt Associates, Bethesda, MD
Liza Solomon, MHS, DrPH, U.S. Health Division, Abt Associates, Bethesda, MD
Joseph Gasper, PhD, U.S. Health Division, Abt Associates, Bethesda, MD
W. Alexander Orr, MPH, U.S. Health Division, Abt Associates, Durham, NC
Chris Flygare, MA, U.S. Health Division, Abt Associates, Cambridge, MD
Luke Shouse, MD, MPH, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Elizabeth DiNenno, PhD, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Patrick Sullivan, DVM, PhD, Rollins School of Public Health, Emory University, Atlanta, GA
Background: Timely linkage to care after diagnosis of HIV is critical to optimizing patient outcomes but has proved challenging. The CDC-funded MSM Testing Initiative (MTI) was designed to test and identify previously undiagnosed men who have sex with men (MSM) and link them to medical care within 90 days after HIV diagnosis. We analyzed variables correlated with time to linkage to care.

Methods:  Survival analysis was used to estimate the distribution of time to linkage. Cox proportional hazard models examined the time to linkage as a function of client and testing characteristics.                               

Results:  Of the 1512 men with newly-diagnosed HIV included in the analysis, 21% were linked to care on the same day as the diagnosis, 50% were linked by 21 days, and 69% were linked by 90 days.  Adjusted hazard ratios (AHRs) show that time to linkage was longer for Blacks (AHR=.79; p=.03 versus White) those who reported sex with an injecting drug user (AHR=.61; p=.02), and those who were tested at non-clinical venues e.g. bars/clubs/public areas (AHR=.36, p=.0001 versus clinical venues). Of those tested at a clinical HIV testing site, 94% were linked within 90 days compared to 59% of those tested at bars, clubs or adult entertainment venues.

Conclusions: Men diagnosed with HIV who were tested in non-clinical venues were less likely to be linked to care within 90 days compared to those tested in clinical HIV testing sites.  Additional efforts are needed to enhance linkage to care strategies among high-risk populations in non-traditional testing venues.

Learning Areas:

Program planning
Provision of health care to the public
Public health or related research

Learning Objectives:
Identify predictors of successful linkage to care among newly diagnosed HIV positive MSM tested through an HIV testing initiative. Discuss the implications of venue-based HIV testing on linkage to care among MSM.

Keyword(s): HIV/AIDS, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the project director or principal investigator of multiple federally funded projects focusing on HIV prevention and linkage to care among MSM. Among my scientific interests has been the evaluation of strategies for recruiting high-risk MSM into testing.
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: 2031.0: HIV/AIDS Care