Longitudinal outcomes of HIV- infected persons re-engaged in care using a community-based re-engagement approach

ABSTRACT

Re-engaging people living with HIV (PLWH) who are out of care (OOC) is of utmost importance to ending the HIV epidemic in the U.S. We used DC Department of Health (DCDOH) HIV surveillance data to determine whether re-engaging PLWH results in improved long-term clinical outcomes. PLWH identified as OOC for 6–12 months at both the clinic-level and using DCDOH data were targeted for re-engagement efforts through Recapture Blitz (RB). Uni- and bivariate analyses were conducted comparing engagement in care (EIC), CD4 counts, and viral suppression (VS) at 6, 12, and 18-months post-re-engagement between persons re-engaged through RB and those not re-engaged via RB. Of the 569 PLWH contacted; 57 were re-engaged through RB, 46 were not but may have reengaged on their own. Compared to those not re-engaged via RB, at 18-months of follow-up, more PLWH re-engaged through RB were EIC (71.9% vs. 56.5%) and VS (52.6% vs. 30.4%). Higher proportions of PLWH re-engaged through RB were virally suppressed at 6, 12, and 18-months (p = 0.0238, p = 0.0347, p = 0.0238, respectively). Combining surveillance and clinical data to identify persons OOC allowed for successful re-engagement and improved longer-term outcomes post-re-engagement, underscoring the importance of re-engagement efforts to improve rates of retention and viral suppression.

KEYWORDS:

• HIV
• surveillance
• engagement in care
• linkage to care
• viral suppression

Acknowledgement

All authors from the George Washington University, and the District of Columbia Department of Health, reviewed and approved the final draft of the paper. Additionally, under the Partnership contract, the District of Columbia Department of Health had the right to review and approve the final version of the manuscript. Portions of this paper were presented as an oral presentation at the 2015 Conference on Retroviruses and Opportunistic Infections in Seattle, Washington, 26 February 2015, “Re-engagement in Care Leads to Sustained Engagement and Viral Suppression”, Abstract 854.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This analysis was funded in part through the Public Health/Academic Partnership between the District of Columbia, Department of Health, HIV/AIDS, Hepatitis, STD, TB Administration and The George Washington University Milken Institute School of Public Health, Department of Epidemiology and Biostatistics (Contract Number POHC-2006-C-0030).