Increased reengagement of out-of-care HIV patients using Lost & Found, a clinic-based intervention. (15th March 2022)

• Record Type: Journal Article
• Authors: Linthwaite, Blake; Kronfli, Nadine; Marbaniang, Ivan; Ruppenthal, Luciana; Lessard, David; Engler, Kim; Lebouché, Bertrand; Cox, Joseph
• Is Part Of: AIDS. Volume 36:Number 4(2022)
• Publication Date: 2022-03-15
• Subjects: data to care -- HIV -- implementation science -- lost to follow-up -- not in care -- out of care -- reengagement; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000003147
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Background: Negative health outcomes associated with being out of HIV care (OOC) warrant reengagement strategies. We aimed to assess effectiveness of Lost & Found, a clinic-based intervention to identify and reengage OOC patients. Methods: Developed and delivered using implementation science, Lost & Found consists of two core elements: identification, operationalized through nurse validation of a real-time list of possible OOC patients; and contact, via nurse-led phone calls. It was implemented over a 12-month period (2018–2019) at the Chronic Viral Illness Service, McGill University Health Centre (CVIS-MUHC) during a type-II implementation-effectiveness hybrid pilot study. Descriptive outcomes of interest were identification as possibly OOC, OOC confirmation, contact, and successful reengagement. We present results from a pre-post analysis comparing overall reengagement to the year prior, using robust Poisson regression controlled for sex, age, and Canadian birth. Time to reengagement is reported using a Cox proportional hazards model. Results: Over half (56%; 1312 of 2354) of CVIS-MUHC patients were identified as possibly OOC. Among these, 44% ( n = 578) were followed elsewhere, 19% ( n = 249) engaged in care, 3% ( n = 33) deceased, 2% ( n = 29) otherwise not followed, and 32% ( n = 423) OOC. Of OOC patients contacted (85%; 359/423), 250 (70%) reengaged and 40 (11%) had upcoming appointments; the remainder were unreachable, declined care, or missed given appointments. Pre-post results indicate people who received Lost & Found were 1.18 [95% confidence interval (CI) 1.02–1.36] times more likely to reengage, and reengaged a median 55 days (95% CI 14–98) sooner. Conclusion: Lost & Found may be a viable clinic-based reengagement intervention for OOC patients. More robust evaluations are needed.