A major roadblock against widespread viral suppression in the HIV population is the fact that many who test positive drop out of care. In an effort to help tackle the problem, Project Inform held a think tank in San Francisco with representatives from AIDS service organizations and health departments.
The fruits of their collective efforts are new guidelines issued to health departments urging them to partner with local service providers in an effort to track down people who have been lost to care. Recently, health departments in Washington, DC, Seattle and Louisiana have used the surveillance data they collect on CD4 and viral load test results to help providers with such an effort—determining, for example, if someone has moved, is seeking care elsewhere or has died.
The Project Inform report urges health departments to reach out to various concerned parties, especially those living with the virus, when planning these partnerships.
Acknowledging that worries about privacy will inevitably arise, David Evans, director of research and advocacy at Project Inform, stresses that the stakes are high. “Those who are lost to care typically aren’t coming back into care until they’re ill,” he says. “I think anything we can do within reason and within good ethical conduct to get people re-engaged in care is really important.”