accommodate open access by having each attending available
for walk in patients for 1 h each day. The clinic has also been
organized to provide comprehensive care including expert
nursing, mental health, social work, and nutrition services in
addition to medical care in order to further ease patient access
to care. Gardner et al.
found that there was a 60% increase in
linkage-to-care rates for patients who were contacted by a case
manager within 6 months of their HIV diagnosis compared
with those who had been diagnosed with HIV between 6 and
12 months earlier. It is encouraging that the linkage rates for
both newly diagnosed patients and known positive patients
are similar and provides evidence that this type of linkage
mechanism may be more effective for all types of patients.
Implementation of a successful linkage mechanism within
an ED HIV testing program could help to alleviate the dis-
proportionate burden of poor HIV outcomes that currently
rests upon minority groups of lower socioeconomic status.
high rate of successful linkage to outpatient care within 30 days
of diagnosis in the ED using existing staff could be replicated
by other ED testing programs by making testers responsible for
linkage and becoming a resource for the patients.
Data were presented in part at: XVII International AIDS
Conference, Mexico City, Mexico, August 3–8, 2008; National
Summit on HIV Diagnosis, Prevention, and Access to Care,
Washington, D.C., November 19–21, 2008.
Funding for this study was provided by: Public Health
Solution of New York City, Inc/ HIV Care Services (PHS/
HIVCS), Contract # 07-RTX-583 for HIV Rapid Testing in
Funding for this study was partially provided by the
New York City Department of Health and Mental Hygiene
RTX-583 and the U.S. National Institutes of Health Institute
of Child Health and Human Development Grant #5K23-
Author Disclosure Statement
No competing ﬁnancial interests exist.
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