Skip to main content
Log in

Predictors of Successful HIV Care Re-engagement Among Persons Poorly Engaged in HIV Care

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The Data to Care (D2C) strategy uses HIV surveillance data to identify persons living with HIV (PLWH) who are poorly engaged in care and offers assistance with care re-engagement. We evaluated HIV care re-engagement among PLWH in Seattle & King County, Washington after participation in a D2C program and determined whether variables available at the time of the D2C interview predicted subsequent re-engagement in care. We defined successful re-engagement as surveillance evidence of either continuous care engagement (≥ 2 CD4 counts or HIV RNA results ≥ 60 days apart) or viral suppression (≥ 1 HIV RNA < 200 copies/mL) in the year following the D2C interview. Predictor variables included client characteristics, beliefs about HIV care, and scores on psychosocial assessment scales. Half of participants successfully re-engaged in care. We did not find any significant predictors of re-engagement except viral suppression at the time of the D2C interview. Close follow-up is needed to identify which D2C participants need additional assistance re-engaging in care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Understanding the HIV Care Continuum [Internet]. 2018. https://www.cdc.gov/hiv/pdf/library/factsheets/cdc-hiv-care-continuum.pdf. Accessed 9 Feb 2019.

  2. 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 [Internet]. 2009;23(1):41–9.

    Article  Google Scholar 

  3. Giordano TP, Gifford AL, White AC, Suarez-Almazor ME, Rabeneck L, Hartman C, et al. Retention in care: a challenge to survival with HIV infection. Clin Infect Dis [Internet]. 2007;44(11):1493–9.

    Article  Google Scholar 

  4. Data to care: improving health and prevention [Internet]. 2015. https://effectiveinterventions.cdc.gov/en/HighImpactPrevention/PublicHealthStrategies/DatatoCare.aspx. Accessed 9 Dec 2016.

  5. Dombrowski JC, Simoni JM, Katz DA, Golden MR. Barriers to HIV care and treatment among participants in a public health HIV care relinkage program. AIDS Patient Care STDS [Internet]. 2015;29(5):279–87.

    Article  Google Scholar 

  6. Sweeney P, Gardner LI, Buchacz K, Garland PM, Mugavero MJ, Bosshart JT, et al. Shifting the paradigm: using HIV surveillance data as a foundation for improving HIV care and preventing HIV infection. Milbank Q. 2013;91(3):558–603.

    Article  Google Scholar 

  7. Dombrowski JC, Hughes JP, Buskin SE, Bennett A, Katz D, Fleming M, et al. A cluster randomized evaluation of a health department data to care intervention designed to increase engagement in HIV care and antiretroviral use. Sex Transm Dis. 2018;45(6):361–7.

    Article  Google Scholar 

  8. Dombrowski JC, Ramchandani M, Dhanireddy S, Harrington R, Moore A, Golden M. The max clinic: medical care designed to engage the hardest-to-reach persons living with HIV in Seattle and King County. Washington. AIDS Patient Care STDS. 2018;32(4):149–56.

    Article  Google Scholar 

  9. Valdiserri RO, Forsyth AD, Yakovchenko V, Koh HK. Measuring what matters: development of standard HIV core indicators across the U.S. Department of health and human services. Public Health Rep. 2013;128(5):354–9.

    Article  Google Scholar 

  10. Public Health – Seattle & King County and Washington State Department of Health. Washington State/Seattle & King County HIV/AIDS Epidemiology Report, 2016. Published 2017; Volume 5. https://www.kingcounty.gov/depts/health/communicable-diseases/hiv-std/patients/epidemiology/~/media/depts/health/communicable-diseases/documents/hivstd/2016-hiv-aids-epidemiology-annual-report.ashx. Accessed 12 Feb 2019.

  11. Centers for Disease Control and Prevention. Behavioral and clinical characteristics of persons receiving medical care for HIV infection—Medical Monitoring Project, United States, 2013 Cycle (June 2013–May 2014). HIV Surveillance Special Report 16. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-special-report-number-20.pdf. Accessed 12 Feb 2019.

  12. Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression: two questions are as good as many. J Gen Intern Med. 1997;12(7):439–45.

    Article  CAS  Google Scholar 

  13. Bosanquet K, Bailey D, Gilbody S, Harden M, Manea L, Nutbrown S, et al. Diagnostic accuracy of the Whooley questions for the identification of depression: a diagnostic meta-analysis. BMJ Open. 2015;5(12):e008913.

    Article  Google Scholar 

  14. Bulsara SM, Wainberg ML, Newton-John TRO. Predictors of adult retention in HIV care: a systematic review. AIDS Behav. 2016;22(3):752–64.

    Article  Google Scholar 

  15. McCoy K, Waldrop-Valverde D, Balderson BH, Mahoney C, Catz S. Correlates of antiretroviral therapy adherence among HIV-infected older adults. J Int Assoc Provid AIDS Care. 2016;15(3):248–55.

    Article  Google Scholar 

  16. Reynolds NR, Testa MA, Marc LG, Chesney MA, Neidig JL, Smith SR, et al. Factors influencing medication adherence beliefs and self-efficacy in persons naive to antiretroviral therapy: a multicenter, cross-sectional study. AIDS Behav. 2004;8(2):141–50.

    Article  Google Scholar 

  17. Sayles JN, Wong MD, Kinsler JJ, Martins D, Cunningham WE. The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV/AIDS. J Gen Intern Med. 2009;24(10):1101–8.

    Article  Google Scholar 

  18. Halkitis PN, Perez-Figueroa RE, Carreiro T, Kingdon MJ, Kupprat SA, Eddy J. Psychosocial burdens negatively impact HIV antiretroviral adherence in gay, bisexual, and other men who have sex with men aged 50 and older. AIDS Care. 2014;26(11):1426–34.

    Article  Google Scholar 

  19. Gonzalez A, Mimiaga MJ, Israel J, Andres Bedoya C, Safren SA. Substance use predictors of poor medication adherence: the role of substance use coping among HIV-infected patients in Opioid dependence treatment. AIDS Behav. 2013;17(1):168–73.

    Article  Google Scholar 

  20. Mahoney JJ, Thompson-Lake DGY, Cooper K, Verrico CD, Newton TF, De La Garza R. A comparison of impulsivity, depressive symptoms, lifetime stress and sensation seeking in healthy controls versus participants with cocaine or methamphetamine use disorders. J Psychopharmacol. 2015;29(1):50–6.

    Article  CAS  Google Scholar 

  21. Hood JE, Buskin SE, Golden MR, Glick SN, Banta-Green C, Dombrowski JC. The changing burden of HIV attributable to methamphetamine among men who have sex with men in King County. Washington. AIDS Patient Care STDS. 2018;32(6):223–33.

    Article  Google Scholar 

  22. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–14.

    Article  CAS  Google Scholar 

  23. Johnson MO, Neilands TB, Dilworth SE, Morin SF, Remien RH, Chesney MA. The role of self-efficacy in HIV treatment adherence: validation of the HIV treatment adherence self-efficacy scale (HIV-ASES). J Behav Med. 2007;30(5):359–70.

    Article  Google Scholar 

  24. Piquero AR, Rosay AB. The reliability and validity of Grasmick et al.’s self-control scale: a comment on Longshore et al.*. Criminology. 1998;36(1):157–74.

    Article  Google Scholar 

  25. Rao D, Feldman BJ, Fredericksen RJ, Crane PK, Simoni JM, Kitahata MM, et al. A Structural equation model of HIV-related stigma, depressive symptoms, and medication adherence. AIDS Behav. 2012;16(3):711–6.

    Article  Google Scholar 

  26. Wight RG, Aneshensel CS, Murphy DA, Miller-Martinez D, Beals KP. Perceived HIV stigma in AIDS caregiving dyads. Soc Sci Med. 2006;62(2):444–56.

    Article  Google Scholar 

  27. Sowell RL, Lowenstein A, Moneyham L, Demi A, Mizuno Y, Seals BF. Resources, stigma, and patterns of disclosure in rural women with HIV infection. Public Health Nurs. 1997;14(5):302–12.

    Article  CAS  Google Scholar 

  28. Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92–100.

    Article  CAS  Google Scholar 

  29. Center for Medicaid and CHIP Services: Children and Adults Health Program Group. 2013 POVERTY GUIDELINES. https://www.medicaid.gov. 2013.

  30. Kelly JD, Hartman C, Graham J, Kallen MA, Giordano TP. Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study. J Assoc Nurses AIDS Care. 2014;25(5):405–13.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by a University of Washington Medical Student Research Training Program to EJC, a grant to JCD from the National Institute of Mental Health (Grant No. 5K23MH090923); the University of Washington Center for AIDS Research (CFAR), an NIH funded program under award number P30AI027757 which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK); and programmatic funding from the Health Resources & Services Administration to Public Health – Seattle & King County and from the Centers for Disease Control and Prevention to the Washington State Department of Health.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth J. Chang.

Ethics declarations

Conflicts of interest

JCD has conducted research unrelated to this work supported by grants to the UW from the following companies: Hologic, Curatek Pharmaceuticals, ELITech and the Quidel Corporation. All other authors report no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chang, E.J., Fleming, M., Nunez, A. et al. Predictors of Successful HIV Care Re-engagement Among Persons Poorly Engaged in HIV Care. AIDS Behav 23, 2490–2497 (2019). https://doi.org/10.1007/s10461-019-02491-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02491-y

Keywords

Navigation