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Interventions to Promote Linkage to and Utilization of HIV Medical Care Among HIV-diagnosed Persons: A Qualitative Systematic Review, 1996–2011

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Abstract

This qualitative systematic review examined interventions that promote linkage to or utilization of HIV care among HIV-diagnosed persons in the United States. We conducted automated searches of electronic databases (i.e., MEDLINE, EMBASE, PsycINFO, CINAHL) and manual searches of journals, reference lists, and listservs. Fourteen studies from 19 published reports between 1996 and 2011 met our inclusion criteria. We developed a three-tier approach, based on strength of study design, to evaluate 6 findings on linkage to care and 18 findings on HIV care utilization. Our review identified similar strategies for the two outcomes, including active coordinator’s role in helping with linking to or utilizing HIV care; offering information and education about HIV care; providing motivational or strengths-based counseling; accompanying clients to medical appointments and helping with appointment coordination. The interventions focused almost exclusively on individual-level factors. More research is recommended to examine interventions that address system and structural barriers.

Resumen

Esta revisión sistemática cualitativa examinó intervenciones que promueven el coneción a o la utilización del cuidado del VIH entre personas diagnosticadas con el VIH en los Estados Unidos. Condujimos búsquedas automatizadas de bases de datos electrónicas (es decir, MEDLINE, EMBASE, PsycINFO, CINAHL) y búsquedas manuales de revistas, listas de la referencia y listservs. Catorce estudios desde 19 informes publicados entre 1996 y 2011 cumplieron nuestros criterios de inclusión. Desarrollamos un enfoque de tres niveles, basado en la fuerza del diseño de estudio, para evaluar 6 conclusiones sobre el coneción al cuidado médico y 18 conclusiones en la utilización de cuidado del VIH. Nuestra revisión identificó estrategias similares para los dos resultados, incluyendo el papel activo del coordinador en ayudando con el coneción a o utilización del cuidado del VIH; ofreciendo de información y educación sobre cuidado del VIH; proporcionando consejería motivacional o basada en fortalezas; acompañando clientes a sus citas médicas; y ayudando con coordinación de las citas. Las intervenciones se concentraron casi exclusivamente en factores de nivel individual. Más investigación es recomendado para examinar intervenciones que se dirigen a barreras sistémicas y estructurales.

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Acknowledgments

We thank other members of the HIV/AIDS Prevention Research Synthesis Team who also contributed to this review (listed alphabetically): Adebukola Adegbite, Terrika Barham, Linda Kay, Khiya Marshall, Theresa Sipe, Maria Luisa Tungol, Heather Waverly Vosburgh, Heather, and Christina White. This work was supported by the Prevention Research Branch, Division of IV/AIDS Prevention, US Centers for Disease Control and Prevention and was not funded by any other organization.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

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Correspondence to Nicole Crepaz.

Appendix: Automated Search Strategy

Appendix: Automated Search Strategy

Database: Medline

Search Interface: OVID

Interface Key

$ = truncation.

ab = abstract.

ti = title.

Subheadings

/co = complications.

/di = diagnosis sh.

/pc = prevention and control.

/th = therapy.

/dt = drug therapy.

/nu = nursing.

/px = psychology.

/tm = transmission.

HIV/HIV Positive Person Mesh and Keywords
  1. 1.

    HIV infections/co, dt, di, nu, pc, px, th, tm

  2. 2.

    HIV infect$.ti,ab

  3. 3.

    (HIV adj4 diagnos$).ti,ab

  4. 4.

    HIV positiv$.ti,ab

  5. 5.

    (HIV adj4 care).ti,ab

  6. 6.

    (HIV adj4 treatment$).ti,ab

  7. 7.

    living with HIV.ti,ab

  8. 8.

    or/1-7

Linking and Retention in Care Mesh and Keywords
  1. 9.

    (access$ adj4 care).ti,ab

  2. 10.

    (access$ adj4 barrier$).ti,ab

  3. 11.

    (access$ adj4 (treatment or service$)).ti,ab

  4. 12.

    (barrier$ adj4 care).ti,ab

  5. 13.

    case management.ti,ab

  6. 14.

    case manager$.ti,ab

  7. 15.

    (decreas$ adj4 barrier$).ti,ab

  8. 16.

    (engag$ adj4 (care or service$)).ti,ab

  9. 17.

    (enroll$ adj4 care).ti,ab

  10. 18.

    ((enter$ or entry) adj4 care).ti,ab

  11. 19.

    ((enter$ or entry) adj4 service$).ti,ab

  12. 20.

    (improv$ adj4 access$).ti,ab

  13. 21.

    (improv$ adj4 retention).ti,ab

  14. 22.

    ((kept or keep$ or return$) adj4 appointment$).ti,ab

  15. 23.

    (link$ adj4 (retain$ or retent$)).ti,ab

  16. 24.

    (link$ adj4 care).ti,ab

  17. 25.

    (link$ adj4 case).ti,ab

  18. 26.

    (link$ adj4 treatment).ti,ab

  19. 27.

    (link$ adj4 service$).ti,ab

  20. 28.

    (outreach adj4 (care or link$ or program$)).ti,ab

  21. 29.

    ((provision or provid$) adj4 (care or service$)).ti,ab

  22. 30.

    (reduc$ adj4 barrier$).ti,ab

  23. 31.

    ((re engag$ or reengag$) adj4 (care or treatment or service$)).ti,ab

  24. 32.

    ((re enter$ or reenter$) adj4 (care or treatment or service$)).ti,ab

  25. 33.

    ((refer or refers or referred or referral$) adj4 (care or medical or treatment or clinic or service$)).ti,ab

  26. 34.

    ((retain$ or retent$) adj4 care).ti,ab

  27. 35.

    (seek$ adj4 (care or treatment$)).ti,ab

  28. 36.

    (utiliz$ adj4 (treatment or care or service$)).ti,ab

  29. 37.

    (medical adj4 (care or treatment or service$)).ti,ab

  30. 38.

    (gap$ adj2 care).ti,ab

  31. 39.

    (visit adj2 (constan$ or consist$)).ti,ab

  32. 40.

    (appointment$ adj2 adher$).ti,ab

  33. 41.

    ((follow-up or follow up) adj2 discontin$).ti,ab

  34. 42.

    ((miss$ or schedul$) adj2 (visit$ or appointment$)).ti,ab

  35. 43.

    ($contin$ adj2 care).ti,ab

  36. 44.

    or/9-43

  37. 45.

    8 and 44

  38. 46.

    Year limits (1996+), Publication Type Limits: Clinical Trial, Controlled Clinical Trial, Corrected and Republished Article, Evaluation Studies, Journal Article, Meta-Analysis, Multicenter Study, Published Erratum, Randomized Controlled Trial, Retraction of Publication, Review, Review Literature, Technical Report, Validation Studies.

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Liau, A., Crepaz, N., Lyles, C.M. et al. Interventions to Promote Linkage to and Utilization of HIV Medical Care Among HIV-diagnosed Persons: A Qualitative Systematic Review, 1996–2011. AIDS Behav 17, 1941–1962 (2013). https://doi.org/10.1007/s10461-013-0435-y

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