Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Dec;27(12):4070-4083.
doi: 10.1007/s10461-023-04121-0. Epub 2023 Jul 31.

Systematic Review and Meta-analysis of Linkage to HIV Care Interventions in the United States, Canada, and Ukraine (2010-2021)

Julie H Levison  1   2 , Paola Del Cueto  3   4 , Jaime Vladimir Mendoza  3 , Dina Ashour  5 , Melis Lydston  6 , Kenneth A Freedberg  3   7   5   4 , Fatma M Shebl  3   5   4
Affiliations
Meta-Analysis

Systematic Review and Meta-analysis of Linkage to HIV Care Interventions in the United States, Canada, and Ukraine (2010-2021)

Julie H Levison et al. AIDS Behav. 2023 Dec.

Abstract

We conducted a systematic review and meta-analysis of interventions targeting linkage to HIV care in the US, Canada, and Europe. We searched six databases (PubMed, Embase, Cochrane Library, Web of Science and CINAHL). Inclusion criteria were English language studies in adults in the US, Canada, or Europe, published January 1, 2010 to January 1, 2021. We synthesized interventions by type and linkage to care outcome. The outcome was cumulative incidence of 3-month linkage. We estimated cumulative incidence ratios of linkage with 95% confidence intervals (CIs). We screened 945 studies; 13 met selection criteria (n = 1 from Canada, n = 1 from Ukraine, n = 11 from the US) and were included after full text review (total 37,549 individuals). The cumulative incidence of 3-month linkage in the intervention group was 0.82 (95% CI 0.68-0.94) and control group 0.71 (95% CI 0.50-0.90); cIR of linkage for intervention versus control was 1.30 (95% CI 1.13, 1.49). Interventions to improve linkage to care after HIV diagnosis warrant further attention.

Keywords: Engagement in care; HIV/AIDS; Linkage to care; Meta-analysis; Systematic review.

PubMed Disclaimer

Conflict of interest statement

All authors have declared that no competing interests exist.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers, and other sources [17]
Fig. 2
Fig. 2
Cumulative incidence of 3-month linkage to care in individual studies, by intervention sub-types compared with controls
Fig. 3
Fig. 3
Cumulative incidence ratio of 3-month linkage to care, overall and by intervention type not restricted to 2-arm studies
Fig. 4
Fig. 4
Cumulative incidence ratio of 3-month linkage to care, overall and by intervention type restricted to 2-arm studies
See this image and copyright information in PMC

References

    1. Shah M, Risher K, Berry SA, Dowdy DW. The epidemiologic and economic impact of improving HIV testing, linkage, and retention in care in the United States. Clin Infect Dis. 2016;62(2):220–229. doi: 10.1093/cid/civ801. - DOI - PMC - PubMed
    1. Ulett KB, Willig JH, Lin HY, Routman JS, Abroms S, Allison J, et al. The therapeutic implications of timely linkage and early retention in HIV care. AIDS Patient Care STDS. 2009;23(1):41–49. doi: 10.1089/apc.2008.0132. - DOI - PMC - PubMed
    1. Robertson M, Laraque F, Mavronicolas H, Braunstein S, Torian L. Linkage and retention in care and the time to HIV viral suppression and viral rebound—New York City. AIDS Care. 2015;27(2):260–267. doi: 10.1080/09540121.2014.959463. - DOI - PubMed
    1. UNAIDS. Understanding fast track: accelerating action to end the AIDS epidemic by 2030. Available from: https://www.unaids.org/sites/default/files/media_asset/201506_JC2743_Und.... Accessed 17 Oct 2022.
    1. The White House. National HIV/AIDS strategy for the United States, updated to 2020, federal action plan. Available from: https://files.hiv.gov/s3fs-public/nhas-update.pdf. Accessed 11 July 2022.