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1652. Equivalent HIV Outcomes for Persons with HIV after Re-engagement in HIV Care with Prior or New Provider

BACKGROUND: New York City (NYC) health department staff assist people with HIV (PWH) deemed out of care (OOC) per NYC HIV Surveillance Registry to re-engage in HIV care with their last known treating provider/parent clinic or, if preferable/necessary (e.g., moved to a new neighborhood), a new NYC pr...

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Detalles Bibliográficos
Autores principales: Udeagu, Chi-Chi N, Shah, Sharmila, Braunstein, Sarah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808954/
http://dx.doi.org/10.1093/ofid/ofz360.1516
Descripción
Sumario:BACKGROUND: New York City (NYC) health department staff assist people with HIV (PWH) deemed out of care (OOC) per NYC HIV Surveillance Registry to re-engage in HIV care with their last known treating provider/parent clinic or, if preferable/necessary (e.g., moved to a new neighborhood), a new NYC provider. We examined retention in care and viral suppression (VS) of PWH re-engaged in care in a group who agreed to return to care and were cared for by either their previous or a new provider. METHODS: We analyzed data from 2009 to 2015 on PWH who had ≥2 CD4 count or viral load (VL) test reports in the NYC HIV Registry who fell out of care and then re-engaged in care. We compared characteristics, timeliness and retention in care (≥2 CD4 or VL, ≥90 days apart) and VS (last VL ≤200 copies/mL) of PWH overall and also according to whether they returned to their last known vs. a new provider in year 2 post re-engagement in care. RESULTS: From 2009–2015, 882 persons were re-engaged in care by the health department. Most were diagnosed 5–10 (27%) or >10 (67%) years prior, and were OOC for 1–3 years (70%) or >3 years (20%). Most re-engaged PWH were male (63%), black (56%) or Hispanic (34%), US-born (79%), aged 30–49 (48%) or ≥50 (40%) years. Risk factors for HIV included heterosexual transmission (39%), male-sex-with-male (26%) or injection drug use (18%). Twenty-two percent had history of homelessness and 5% incarceration. Fifty-one percent and 49% re-engaged in care with their prior or a new provider, respectively. PWH re-engaged with prior providers vs. new providers had lower rates of prior or current homelessness (17% vs. 28%, P = 0.0001), PWH re-engaged to prior vs. new providers had their first lab reports and achieved VS earlier (1 vs. 2 months, and 4 vs. 5 months, respectively (both P < 0.05). Proportions of PWH re-engaged to prior or new providers and retained in care (92% vs. 91%, respectively) or with VS (73% vs. 75%, respectively) in year 2 did not differ. CONCLUSION: Our results show that health department efforts to re-engage previously OOC-PWH in HIV care resulted in more than 70% achieving VS. Assignment to a new provider resulted in earlier VS but did not affect 2-year VS or care retention. PWH who re-engage in care can safely be given the choice between known or new providers. DISCLOSURES: All authors: No reported disclosures.