Re-Linkage and Navigation Outcomes of Sexually-Active Not-in-Care People Living with HIV Identified through a Municipal STD Clinic and Partner Services

Background:  Linking sexually-active persons living with HIV (PLWH) to HIV care is critical to ‘Getting to Zero.’ The San Francisco Department of Public Health LINCS navigation team works to re-link not in care (NIC) PLWH to care.  We describe the navigation outcomes of LINCS clients identified through two distinct referral mechanisms: 1) San Francisco City Clinic (SFCC), the municipal STD clinic and 2) Syphilis and HIV partner services (PS).

Methods:  Since 2015, PLWH seen at SFCC who report being NIC are referred to an onsite LINCS navigator.  Since 2016, names and dates of birth of all partners named from new HIV and HIV+ Syphilis cases through PS are provided to the SFDPH HIV Surveillance Registry to identify those NIC. HIV+ named partners who did not have a viral load in the prior 12 months or who had a detectable viral load >6 months ago are referred for navigation.  Programmatic outcomes of LINCS clients identified through both referral mechanisms are described.

Results:  From 1/2015 to 4/2016, 1721 HIV+ patients were seen at SFCC. Of these, 33 were assigned to navigation, 13 were successfully re-linked to care, 11 were unable to locate, 5 refused and 4 resided outside SF.  From 1/2016 to 4/2016, 405 named partners from new HIV and HIV+ Syphilis cases were cross-matched with HIV Surveillance.  Of these, 41 were NIC, 29 have been assigned to navigation, 12 were confirmed to be in care, 3 were already enrolled in case management, 1 was deceased, 2 were re-linked, 5 were unable to locate, 4 refused, and 2 resided outside SF.

Conclusions:  While re-linkage was higher among NIC patients seen at SFCC than among NIC HIV+ named partners identified though PS, both strategies were useful for identifying NIC PLWH and targeting HIV navigation towards a high priority population of sexually active, unengaged PLWH.