478. Linkage to Care of Newly Diagnosed HIV-infected Patients in Two VA Facilities
Session: Poster Abstract Session: HIV Primary Care
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • IDSA 2011 HIV linkage poster v3.pdf (79.6 kB)
  • Background: HIV testing rates have increased in many healthcare systems, but few data are available regarding whether such patients are successfully linked to medical care.  We present such data for persons newly diagnosed after the implementation of enhanced programs to promote HIV testing at two large urban VA Medical Centers.

    Methods: Programs to promote HIV testing were put in place in Los Angeles in 2005 and Atlanta in 2007.  Data regarding the follow-up of newly diagnosed HIV infection during these time periods were obtained via retrospective review of electronic medical records.

    Results: The table shows the number of new diagnoses (Dx) who were seen in an HIV specialty clinic, started on antiretroviral therapy (Rx) as well as the days (D) from Dx to Rx and the fraction of patients with a viral load (VL) of < 50 HIV-1 RNA copies/ml at 6 and 12 months after starting Rx.  No significant differences were seen between the two sites in any of these parameters. 

     

    Clinic

    D to clinic*

    Rx started

    D from Dx to Rx**

    VL < 50**

    1st CD4

    N

    N

    %

    <91

    <181

    N

    %

    <91

    <181

    <271

    <361

    6 mo

    12 mo

     

    >500

    60

    58

    97%

    75%

    87%

    22

    37%

    23%

    45%

    55%

    59%

    79%

    75%

     

    350-499

    33

    33

    100%

    85%

    91%

    22

    67%

    41%

    41%

    55%

    64%

    80%

    82%

     

    200-349

    36

    35

    97%

    78%

    92%

    33

    92%

    52%

    79%

    91%

    100%

    63%

    88%

     

    < 200

    60

    52

    87%

    75%

    85%

    52

    87%

    81%

    96%

    96%

    96%

    63%

    56%

     

    Total

    189

    178

    94%

    77%

    88%

    129

    68%

    57%

    74%

    81%

    85%

    68%

    71%

     

    *      among all patients seen in clinic
    **     among patients starting therapy

    Conclusion: We previously demonstrated that within these VA facilities, increased HIV testing has resulted in higher CD4 counts and lower VLs at the time of diagnosis.  These data demonstrate that within an integrated care system, such as the VA, the majority of newly diagnosed HIV infected can be seen within 3 months of diagnosis with subsequent high rates of virological suppression on Rx.  Further work is needed to assess the generalizability of these findings, the durability of linkage of care and factors that account for loss to follow-up. 


    Subject Category: H. HIV/AIDS and other retroviruses

    Matthew Bidwell Goetz, MD, Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; Infectious Diseases, VA Greater Los Angeles Healthcare System , Los Angeles, CA and David Rimland, MD, School of Medicine at UCLA, Decatur, GA

    Disclosures:

    M. Bidwell Goetz, None

    D. Rimland, None

    See more of: HIV Primary Care
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.