Table 1.

Comparison of conventional D2C interventions with NYC D2S

Intervention feature	Common D2C challenges	NYC D2S solutions
Surveillance data source	Incompleteness Reporting delays Inaccuracies	Use highly complete and current NYC HIV surveillance registry, maintained in part via special investigations and quality-assurance checks and by pulling in data from multiple sources, including electronic laboratory reporting, partner services, perinatal surveillance, other disease surveillance registries, death registries and other jurisdictions’ HIV registries
Population	Limited to patients presumed out of care (but often found to be in care or otherwise ineligible for follow-up)	Attend to patients virally unsuppressed but in care (thus likely living within jurisdiction and represented with current laboratory reporting)
Outreach	Based on contact details that may be incomplete or outdated in surveillance data Conducted by health department staff (unknown to the patient) or staff of clinics that failed to engage the patient previously	Outreach based on latest contact information from a programme currently serving the patient Mobilise programme staff familiar to the patient and already working with them on patient-identified needs (eg, housing)
Patient support	Reconnection to HIV medical care settings, which may offer scant non-clinical/supportive services	Leverage programmes designed to address psychosocial and structural barriers to adherence, in part via supportive services and patient navigation strategies
Provider support	Notifications/alerts or reports (little if any additional support to providers or their agencies)	Supplement surveillance-based reports with agency capacity-building for next steps Integrate reports and their use with Ryan White continuous QI processes
Primary outcome	Return to HIV care (usually one visit), which patients may otherwise do on their own	Focus on VS (VL<200 copies/mL on any test in 6-month follow-up period)
Study design	Often pre–post or other non-experimental designs	Use RCT to isolate intervention effects from usual-care outcomes

D2C, data to care; D2S, data to suppression; NYC, New York City; QI, quality improvement; RCT, randomised controlled trial; VL, viral load; VS, viral suppression.