"Is a Bird in the Hand Worth 5 in the Bush?": A Comparison of 3 Data-to-Care Referral Strategies on HIV Care Continuum Outcomes in San Francisco.
"Is a Bird in the Hand Worth 5 in the Bush?": A Comparison of 3 Data-to-Care Referral Strategies on HIV Care Continuum Outcomes in San Francisco.
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DOI：
10.1093/ofid/ofaa369
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发表时间：
2020-09
影响因子：
4.2
通讯作者：
Scheer S
中科院分区：
文献类型：
--
作者：
Sachdev DD;Mara E;Hughes AJ;Antunez E;Kohn R;Cohen S;Scheer S
卫生部门利用艾滋病毒监测数据来确定需要重新与艾滋病毒护理联系的艾滋病毒感染者（PWH），这是称为数据到护理（D2C）方法的一部分。识别PWH以进行重新连接的最准确、有效和高效的方法是未知的。我们评估了使用3种D2C转介策略确定的PWH的转介和护理连续性结果：医疗保健提供者，监测和通过匹配电子病历登记处与HIV监测得出的组合列表。参加再联系干预的威尔斯亲王医院接受了长达90天的短期病例管理。计算相对风险和95%置信区间，以比较重新连接前后PWH保留和病毒抑制的比例。持久的病毒抑制定义为在重新连接后12个月内，所有病毒载量测量值均抑制病毒载量。初步调查后，954例转诊中有233例（24%）被定位并入组导航。虽然监测和提供者转介的数量相似，但72%的登记威尔斯亲王医院是由提供者确定的，16%是由监测确定的，12%是由组合列表确定的。总体而言，保留和病毒抑制改善，虽然保留和病毒抑制的相对增加仅在监测或提供者确定的个体中显着。在干预后达到病毒抑制的威尔斯亲王医院中，70%的人仍然保持持久的病毒抑制。与通过监测或组合列表识别的PWH相比，由供应商推荐的PWH更有可能被定位并登记在导航中。总的来说，D2C重新连接的努力改善了保留、病毒抑制和持久的病毒抑制。
Health departments utilize HIV surveillance data to identify people with HIV (PWH) who need re-linkage to HIV care as part of an approach known as Data to Care (D2C.) The most accurate, effective, and efficient method of identifying PWH for re-linkage is unknown. We evaluated referral and care continuum outcomes among PWH identified using 3 D2C referral strategies: health care providers, surveillance, and a combination list derived by matching an electronic medical record registry to HIV surveillance. PWH who were enrolled in the re-linkage intervention received short-term case management for up to 90 days. Relative risks and 95% confidence intervals were calculated to compare proportions of PWH retained and virally suppressed before and after re-linkage. Durable viral suppression was defined as having suppressed viral loads at all viral load measurements in the 12 months after re-linkage. After initial investigation, 233 (24%) of 954 referrals were located and enrolled in navigation. Although the numbers of surveillance and provider referrals were similar, 72% of enrolled PWH were identified by providers, 16% by surveillance, and 12% by combination list. Overall, retention and viral suppression improved, although relative increases in retention and viral suppression were only significant among individuals identified by surveillance or providers. Seventy percent of PWH who achieved viral suppression after the intervention remained durably virally suppressed. PWH referred by providers were more likely to be located and enrolled in navigation than PWH identified by surveillance or combination lists. Overall, D2C re-linkage efforts improved retention, viral suppression, and durable viral suppression.
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影响因子：
4.9
作者：
Bradford, Judith B.;Coleman, Sharon;Cunningham, William
通讯作者：
Cunningham, William
影响因子：
4.4
作者：
Hague, John Christian;John, Betsey;Cranston, Kevin
通讯作者：
Cranston, Kevin
DOI：
10.1097/qai.0000000000000788
发表时间：
2015-12-15
影响因子：
3.6
作者：
Lesko, Catherine R.;Sampson, Lynne A.;Powers, Kimberly A.
通讯作者：
Powers, Kimberly A.
影响因子：
4.4
作者：
Pence BW;Bengtson AM;Boswell S;Christopoulos KA;Crane HM;Geng E;Keruly JC;Mathews WC;Mugavero MJ
通讯作者：
Mugavero MJ
影响因子：
4.4
作者：
Bulsara SM;Wainberg ML;Newton-John TRO
通讯作者：
Newton-John TRO