The promise of outreach for engaging and retaining out-of-care persons in HIV medical care.
ABSTRACT From the beginning of the HIV/AIDS epidemic, outreach workers have been on the frontlines of HIV prevention, working in community venues to increase knowledge and promote behaviors to reduce HIV transmission. As demographics of the HIV-infected population have changed, the need has grown to locate out-of-care individuals and learn how to engage and retain them in HIV care. Through the Health Resources and Services Administration (HRSA) Special Projects of National Significance (SPNS) Outreach Initiative, 10 sites across the United States implemented and evaluated enhanced outreach models designed to increase engagement and retention in HIV care for underserved, disadvantaged HIV-infected individuals. Although the models differed in response to local needs and organizational characteristics, all made use of a common conceptual framework, and all used the same data collection and reporting protocols. Study teams enrolled and provided behavioral interventions to HIV-infected individuals who have been noticeably absent from research and from practice. Their interventions incorporated coaching, skills-building, and education, and were successful in reducing or removing structural, financial, and personal/cultural barriers that interfered with equitable access to HIV care. Desired outcomes of increased engagement and retention in HIV health care were achieved. Results demonstrate that interventions to promote equitable access to HIV care for disadvantaged population groups can be built from outreach models. Qualitative and quantitative analysis of the multisite data indicates that further development and evaluation of outreach-based interventions will result in effective tools for reaching HIV-infected individuals who would otherwise remain without needed care.
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ABSTRACT: We surveyed HIV patients with late-stage disease in southern Vietnam to determine if barriers to access and service quality resulted in late HIV testing and delays from initial diagnosis to entry into HIV care.PLoS ONE 10/2014; 9(10):e108939. · 3.53 Impact Factor
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ABSTRACT: Patient engagement in care and adherence to medication are critical to achieving the full benefits of antiretroviral therapy (ART) among people with HIV infection. A randomized controlled trial in Kenya, WelTelKenya1, showed that an interactive mobile phone text-messaging intervention can improve adherence and viral load suppression. We conducted a pilot study to adapt the WelTel intervention for HIV-infected clients (n = 25) at an HIV clinic in Vancouver, British Columbia. Between April and June 2012, we recruited five participants from five groups: youth (14-24 years), mature (≥50 years), English as a second language, remote (≥3 hours travel time to clinic), and nonsuppressed (CD4+ T cell count <200 cells/mm(3) and viral load ≥250 copies/mL on two consecutive occasions). Participants described the intervention as a useful way to communicate with health care providers, thus increasing the ability to access services, report side effects, and attend appointments.The Journal of the Association of Nurses in AIDS Care: JANAC 04/2014; · 0.96 Impact Factor
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