Author(s): Udeagu CC, Webster TR, Bocour A, Michel P, Shepard CW
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Abstract OBJECTIVE: Locate persons living with HIV (PLWH) presumed lost to follow-up (LTFU), and assist them with partner services and linkage to HIV-related care. DESIGN: Locate and facilitate re-engagement in care for PLWH-LTFU in New York City (NYC), with longitudinal follow-up using HIV surveillance registry. SETTINGS: HIV care facilities and communities in NYC. PATIENTS: PLWH, reported in the NYC HIV surveillance registry, who had a NYC care provider and residential address at last report in the registry. Presumed-LTFU was defined as having no CD4+ or viral load during the most recent 9 months during the study period July 2008-December 2010. INTERVENTION: Case-workers conducted public health investigation to locate PLWH presumed-LTFU and offered them assistance with partner and linkage-to-care services. MAIN OUTCOME MEASURES: Results of partner and linkage-to-care services, and reasons for LTFU. RESULTS: From July 2008 to December 2010, 797 PLWH presumed-LTFU were prioritized for investigation; 14\% were never located. Of the 689 located, 33\% were current to care, 5\% had moved or were incarcerated, 2\% had died, and 59\% (409) were verified to be LTFU. Once located, 77\% (315/409) accepted clinic appointments, and 57\% (232/409) returned to care. Among the 161 who provided reasons for LTFU, the most commonly reported was 'felt well' (41\%). CONCLUSIONS: Health department case-workers helped more than half PLWH-LTFU re-engage in HIV medical care. HIV prevention strategies must include efforts to re-engage PLWH-LTFU in care, for treatment consideration under current treatment guidelines to improve their clinical status and decrease transmission risk.
This article was published in AIDS
and referenced in Journal of AIDS & Clinical Research