Development of an Integrated Approach for Linkage to Care

Background:  In 2015, there were 541 newly diagnosed HIV infections (17.5 per 100,000) in Mississippi.  Of the 10,000 plus residents living with the disease in Mississippi, 52% are estimated to be out of care.  In order to promote viral suppression, it is believed that those who are diagnosed should promptly enter into care.  The integration between STD and HIV programs can expedite linkage to care (LTC) by alleviating data sharing barriers that may occur.  

Methods:  Protocols were developed for initial linkage to care and reengagement to be used by staff in Ryan White HIV Care and in Partner Services programs who work within the state STD Program.    Complementary activities were integrated into both programs following training sessions about the established protocols and use of the PRISM case management tool.  Activities included post-test counseling, partner elicitation and provider referral.  LTC activities were documented in PRISM. A LTC summary report is provided by district supervisors each month.

Results:  The program evaluated the effectiveness of the integrated approach for LTC by observing various performance measures based on the number of newly reported HIV cases and individuals out of care during the reporting period.  Data from the November 2015 through March 2016 Report period revealed 137 new cases of HIV were reported.   Of that number, 122 (89%) were provided partner services and 104 (76%) were linked to care.  Also, during the report period, 114 were re-engaged based on reengagement sources including out of care list from eHARS data.  

Conclusions:  Findings suggest that an established protocol including integration of STD and HIV programs provides a more transparent path for linkage to care which can lead to the promotion of viral load suppression.  Such process also reduces staff uncertainty and promotes increased productivity.