Using Data-To-Care Strategies to Optimize the HIV Care Continuum in Connecticut: Results From a Randomized Controlled Trial.

Autor:	Machavariani E; Department of Internal Medicine, Section of Infectious Disease, HIV/AIDS Program, Yale University School of Medicine, New Haven, CT., Miceli J; Department of Internal Medicine, Section of Infectious Disease, HIV/AIDS Program, Yale University School of Medicine, New Haven, CT., Altice FL; Department of Internal Medicine, Section of Infectious Disease, HIV/AIDS Program, Yale University School of Medicine, New Haven, CT.; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT., Fanfair RN; Centers for Disease Control and Prevention, Atlanta, GA; and., Speers S; Connecticut Department of Public Health, Hartford, CT., Nichols L; Department of Internal Medicine, Section of Infectious Disease, HIV/AIDS Program, Yale University School of Medicine, New Haven, CT., Jenkins H; Connecticut Department of Public Health, Hartford, CT., Villanueva M; Department of Internal Medicine, Section of Infectious Disease, HIV/AIDS Program, Yale University School of Medicine, New Haven, CT.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2024 May 01; Vol. 96 (1), pp. 40-50.
DOI:	10.1097/QAI.0000000000003391
Abstrakt:	Background: Re-engaging people with HIV who are newly out-of-care remains challenging. Data-to-care (D2C) is a potential strategy to re-engage such individuals. Methods: A prospective randomized controlled trial compared a D2C strategy using a disease intervention specialist (DIS) vs standard of care where 23 HIV clinics in 3 counties in Connecticut could re-engage clients using existing methods. Using a data reconciliation process to confirm being newly out-of-care, 655 participants were randomized to DIS (N = 333) or standard of care (N = 322). HIV care continuum outcomes included re-engagement at 90 days, retention in care, and viral suppression by 12 months. Multivariable regression models were used to assess factors predictive of attaining HIV care continuum outcomes. Results: Participants randomized to DIS were more likely to be re-engaged at 90 days (adjusted odds ratios [aOR] = 1.42, P = 0.045). Independent predictors of re-engagement at 90 days were age older than 40 years (aOR = 1.84, P = 0.012) and perinatal HIV risk category (aOR = 3.19, P = 0.030). Predictors of retention at 12 months included re-engagement at 90 days (aOR = 10.31, P < 0.001), drug injection HIV risk category (aOR = 1.83, P = 0.032), detectable HIV-1 RNA before randomization (aOR = 0.40, P = 0.003), and county (Hartford aOR = 1.74, P = 0.049; New Haven aOR = 1.80, P = 0.030). Predictors of viral suppression included re-engagement at 90 days (aOR = 2.85, P < 0.001), retention in HIV care (aOR = 7.07, P < 0.001), and detectable HIV-1 RNA prerandomization (aOR = 0.23, P < 0.001). Conclusions: A D2C strategy significantly improved re-engagement at 90 days. Early re-engagement improved downstream benefits along the HIV care continuum like retention in care and viral suppression at 12 months. Moreover, other factors predictive of care continuum outcomes can be used to improve D2C strategies. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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