HIV: your primary care patient has just been diagnosed. Now what?

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Takeaway

  • Immediate linkage to care can significantly increase the number of patients on antiretroviral treatment (ART) and can reduce risk of transmitting HIV to others.
  • As soon as a patient is diagnosed with HIV, they should be offered mental health care, addiction treatment, harm-reduction services, as well as housing and financial support. This increases retention in care and ART adherence.

Key results

  • Patients should be linked to HIV care at time of HIV diagnosis or even before confirmatory test results come in. Studies that did this increased HIV care rates by more than 15%.
  • Patients should immediately be offered ancillary services, such as addiction treatment, mental health services, harm reduction, and housing and financial support.

Study design

  • Systematic review and meta-analysis.

Limitations

  • Lack of standardized mechanisms for devising best practices made identifying true best practices difficult.
  • Increases in linkage to and retention in care in these studies were not subjected to inferential statistics, so it’s hard to tell if the interventions were clinically significant.
  • Most studies were conducted in the US, and other countries may not have the resources to provide such care.

Why this matters

  • Tens of thousands of people are newly diagnosed with HIV every year in the US.