An Integrated Service Delivery Model to Identify Persons Living with HIV and to Provide Linkage to HIV Treatment and Care in Prioritized Neighborhoods: A Geotargeted, Program Outcome Study
| Autor: | Diane S. Saint-Victor, Marcia McDonnell Holstad, Neena Smith-Bankhead, Paula M. Frew, Dazon Dixon Diallo, Jay Schamel, Carlos del Rio, Matthew Archibald, Elizabeth D. Fox |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Gerontology
education.field_of_study medicine.medical_specialty Original Paper human immunodeficiency virus prevention Referral human immunodeficiency virus Service delivery framework business.industry Public health Multilevel model Population Public Health Environmental and Occupational Health Psychological intervention Health Informatics community-based organizations racial/ethnic minorities human immunodeficiency virus testing High-Impact Prevention medicine education business Socioeconomic status Psychosocial |
| Zdroj: | JMIR Public Health and Surveillance |
| ISSN: | 2369-2960 |
| Popis: | Background: Recent studies have demonstrated that high human immunodeficiency virus (HIV) prevalence (2.1%) rates exist in “high-risk areas” of US cities that are comparable to rates in developing nations. Community-based interventions (CBIs) have demonstrated potential for improving HIV testing in these areas, thereby facilitating early entry and engagement in the HIV continuum of care. By encouraging neighborhood-based community participation through an organized community coalition, Project LINK sought to demonstrate the potential of the CBI concept to improve widespread HIV testing and referral in an area characterized by high poverty and HIV prevalence with few existing HIV-related services. Objective: This study examines the influence of Project LINK to improve linkage-to-care and HIV engagement among residents of its target neighborhoods. Methods: Using a venue-based sampling strategy, survey participants were selected from among all adult participants aged 18 years or more at Project LINK community events (n=547). We explored multilevel factors influencing continuum-of-care outcomes (linkage to HIV testing and CBI network referral) through combined geospatial-survey analyses utilizing hierarchical linear model methodologies and random-intercept models that adjusted for baseline effect differences among zip codes. The study specifically examined participant CBI utilization and engagement in relation to individual and psychosocial factors, as well as neighborhood characteristics including the availability of HIV testing services, and the extent of local prevention, education, and clinical support services. Results: Study participants indicated strong mean intention to test for HIV using CBI agencies (mean 8.66 on 10-point scale [SD 2.51]) and to facilitate referrals to the program (mean 8.81 on 10-point scale [SD 1.86]). Individual-level effects were consistent across simple multiple regression and random-effects models, as well as multilevel models. Participants with lower income expressed greater intentions to obtain HIV tests through LINK (P |
| Databáze: | OpenAIRE |
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