The Effects of Patient Navigation on HIV Viral Load Suppression in Rural Eastern North Carolina

Background: Patient advocacy navigation (PAN), a model that may influence the treatment outcomes of HIV-positive individuals, decrease barriers to care and improve health outcomes among persons living with HIV/AIDS. We examined viral load suppression on newly diagnosed HIV patients between two groups – those who chose PAN and those who declined (non-PAN).

Methods: A retrospective chart review was utilized to obtain data between January, 2012 and December, 2014 in eastern North Carolina. Demographics and laboratory information, including viral suppression at 3, 6, and 12 months were obtained. Simple linear regression was used to calculate odds ratios (ORs) with their respective 95% confidence intervals (CIs). Exact methods were used as indicated by the data.

Results: Among 115 patients, those choosing PAN (70%; 95% CI, 60.6-77.5) were, on average, two years older than non-PAN patients, and majority were Black (70%), male (80%), and homosexual (52%).At three months, PAN patients were 2.55 times more likely than non-PAN patients to exhibit viral load suppression (82.5% vs 65.7%, respectively; CI, 0.99-6.08; p=.0477); at six months, 2.67 times more likely (90.0% vs 77.1%, respectively; CI, 0.90-7.95; p=.0738), and at twelve months, 6.42 times more likely (96.3% vs 80.0%, respectively; CI, 1.66-31.39; p=.0103).

Conclusion: These data suggest that the patient navigation model influences viral load suppression. PAN patients showed greater likelihoods of maintaining viral load suppression over time. Future prospective studies are needed to better evaluate the effect of continued participation in PAN programs on health outcomes.