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Meta-Analysis
. 2022 May 1;36(6):853-862.
doi: 10.1097/QAD.0000000000003172. Epub 2022 Jan 12.

Strategies to improve HIV care outcomes for people with HIV who are out of care

Darrel H Higa  1 , Nicole Crepaz  1 , Mary M Mullins  1 , Adebukola Adegbite-Johnson  2 , Jayleen K L Gunn  1   3 , Christa Denard  2 , Yuko Mizuno  1 ; the Prevention Research Synthesis Project
Affiliations
Meta-Analysis

Strategies to improve HIV care outcomes for people with HIV who are out of care

Darrel H Higa et al. AIDS. .

Abstract

Objective: The aim of this study was to evaluate the effectiveness of five intervention strategies: patient navigation, appointment help/alerts, psychosocial support, transportation/appointment accompaniment, and data-to-care on HIV care outcomes among persons with HIV (PWH) who are out of care (OOC).

Design: A systematic review with meta-analysis.

Methods: We searched CDC's Prevention Research Synthesis (PRS) Project's cumulative HIV database to identify intervention studies conducted in the U.S., published between 2000 and 2020 that included comparisons between groups or prepost, and reported at least one relevant outcome (i.e. re-engagement or retention in HIV care, and viral suppression). Effect sizes were meta-analyzed using random-effect models to assess intervention effectiveness.

Results: Thirty-nine studies reporting on 42 unique interventions met the inclusion criteria. Overall, intervention strategies are effective in improving re-engagement in care [odds ratio (OR) = 1.79;95% confidence interval (95% CI): 1.36-2.36, k = 14], retention in care (OR = 2.01; 95% CI: 1.64-2.64, k = 22), and viral suppression (OR = 2.50;95% CI: 1.87-3.34, k = 27). Patient navigation, appointment help/alerts, psychosocial support, and transportation/appointment accompaniment improved all three HIV care outcomes. Data-to-care improved re-engagement and retention but had insufficient evidence for viral suppression.

Conclusion: Several strategies are effective for improving HIV care outcomes among PWH who are OOC. More work is still needed for consistent definitions of OOC and HIV care outcomes, better reporting of intervention and cost data, and identifying how best to implement and scale-up effective strategies to engage and retain OOC PWH in care and reach the ending the HIV epidemic goals.

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Figures

Figure 1:
Figure 1:
Forest plots for Re-engagement and Retention in HIV Care
Figure 2:
Figure 2:
Forest plot for Viral suppression
See this image and copyright information in PMC

References

    1. Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV epidemic: a plan for the United States. JAMA 2019; 321(9):844–845. - PubMed
    1. Li Z, Purcell DW, Sansom SL, Hayes D, Hall HI. Vital Signs: HIV transmission along the continuum of care - United States, 2016. MMWR Morb Mortal Wkly Rep 2019; 68(11):267–272. - PMC - PubMed
    1. Bulsara SM, Wainberg ML, Newton-John TRO. Predictors of adult retention in HIV care: a systematic review. AIDS Behav 2018; 22(3):752–764. - PMC - PubMed
    1. Craw JA, Bradley H, Gremel G, West BT, Duke CC, Beer L, et al. Retention in care services reported by HIV care providers in the United States, 2013 to 2014. J Int Assoc Provid AIDS Care 2017; 16(5):460–466. - PMC - PubMed
    1. Dandachi D, May SB, Davila JA, Cully J, Amico KR, Kallen MA, et al. The association of unmet needs with subsequent retention in care and HIV suppression among hospitalized patients with HIV who are out of care. J Acquir Immune Defic Syndr 2019; 80(1):64–72. - PMC - PubMed

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