May 28, 2013
Caseworkers Link People 'Lost to Follow-up' Into HIV Care
In an effort to chip away at the high proportion of people with HIV who are not successfully engaged into regular care following an HIV diagnosis, New York City caseworkers successfully linked half of those who had been “lost to follow-up,” aidsmap reports. Publishing their findings in the online edition of the journal AIDS, investigators described the efforts of caseworkers who used mandatory names-based reporting of HIV test results as well as recorded viral load and CD4 tests to track down the 797 New Yorkers who appeared to be lost to follow-up between July 2008 and December 2010.
The caseworkers contacted those lost to follow-up to find out if they were indeed not receiving medical care and offered to help link them to care if necessary. They could not locate 113 (14 percent) of the 797 people, and 46 (7 percent) had either moved away from the city, been incarcerated or died. Of the remaining 638 people, a third were receiving HIV care, 73 percent of whom were misidentified as lost to follow-up as a result of clerical errors.
Thus, 409 people were both located and officially lost to follow-up. Fifty-nine percent returned to care thanks to the caseworkers’ efforts, and after a year 48 percent of the total had made two doctor visits and had received CD4 and viral load screens each time.
After interviewing 161 of those confirmed lost to follow-up, the caseworkers found that the most common reason (41 percent) for not engaging in HIV care was that people “felt well.”
Indicating that “treatment as prevention” cannot successfully curb the HIV epidemic unless more people living with the virus are in care and on successful antiretrovirals, the study authors concluded that “HIV prevention strategies must include efforts to re-engage [people living with HIV who are lost to follow-up] in care…to improve their clinical status and decrease transmission risk.”
To read the aidsmap story, click here.
To read the study abstract, click here.
Search: HIV, lost to follow-up, retention, New York City, caseworkers, surveillance, AIDS.
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