Table 4.
Sensitivity, specificity, PPV, and NPV for each linkage metric examined, with virologic suppression as the outcome, of 1781 persons newly diagnosed with HIV in Philadelphia in 2007 and 2008.*
| Measure | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | AUC | Adjusted AUC† |
|---|---|---|---|---|---|---|
| Visit in 30 days | 0.35 (0.31-0.40) | 0.84 (0.82-0.86) | 0.41 (0.35-0.46) | 0.81 (0.79-0.83) | 0.597 | 0.689 |
| Visit in 60 days | 0.45 (0.41-0.50) | 0.79 (0.77-0.81) | 0.40 (0.36-0.45) | 0.83 (0.80-0.85) | 0.623 | 0.705 |
| Visit in 90 days | 0.51 (0.47-0.56) | 0.77 (0.75-0.79) | 0.41 (0.36-0.45) | 0.84 (0.82-0.86) | 0.642 | 0.717 |
| Visit in 180 days | 0.60 (0.55-0.65) | 0.73 (0.71-0.76) | 0.41 (0.37-0.45) | 0.86 (0.83-0.88) | 0.666 | 0.736 |
| Visit in 365 days | 0.67 (0.63-0.72) | 0.69 (0.67-0.72) | 0.40 (0.36-0.44) | 0.87 (0.85-0.89) | 0.683 | 0.751 |
| Visit between 21 and 60 days | 0.42 (0.37-0.47) | 0.84 (0.82-0.86) | 0.45 (0.40-0.50) | 0.83 (0.80-0.84) | 0.630 | 0.714 |
| Visit between 21 and 90 days | 0.49 (0.44-0.54) | 0.80 (0.78-0.82) | 0.44 (0.39-0.48) | 0.84 (0.82-0.86) | 0.648 | 0.726 |
| Visit between 21 and 180 days | 0.58 (0.53-0.63) | 0.76 (0.73-0.78) | 0.42 (0.38-0.47) | 0.86 (0.83-0.88) | 0.670 | 0.742 |
| Visit between 21 and 365 days | 0.67 (0.63-0.72) | 0.71 (0.68-0.73) | 0.41 (0.38-0.45) | 0.88 (0.85-0.89) | 0.690 | 0.757 |
| Two visits in 90 days | 0.39 (0.35-0.44) | 0.84 (0.82-0.86) | 0.43 (0.38-0.48) | 0.82 (0.80-0.84) | 0.615 | 0.701 |
| Two visits in 180 days | 0.51 (0.46-0.56) | 0.79 (0.77-0.81) | 0.43 (0.38-0.47) | 0.84 (0.82-0.86) | 0.649 | 0.723 |
| Two visits in 365 days | 0.61 (0.56-0.65) | 0.74 (0.71-0.76) | 0.42 (0.38-0.46) | 0.86 (0.84-0.88) | 0.673 | 0.742 |
| Two visits in 180 days, separated by 90 days | 0.37 (0.32-0.41) | 0.88 (0.87-0.90) | 0.49 (0.43-0.55) | 0.82 (0.80-0.84) | 0.558 | 0.694 |
| Two visits in 365 days, separated by 90 days | 0.59 (0.54-0.64) | 0.81 (0.79-0.83) | 0.49 (0.44-0.53) | 0.87 (0.85-0.88) | 0.596 | 0.725 |
| Tests in 30 days | 0.68 (0.63-0.72) | 0.46 (0.44-0.49) | 0.28 (0.25-0.31) | 0.83 (0.80-0.85) | 0.572 | 0.663 |
| Tests in 60 days | 0.80 (0.76-0.84) | 0.36 (0.34-0.39) | 0.28 (0.25-0.30) | 0.86 (0.82-0.88) | 0.582 | 0.673 |
| Tests in 90 days | 0.85 (0.81-0.88) | 0.32 (0.30-0.35) | 0.28 (0.25-0.30) | 0.87 (0.84-0.90) | 0.585 | 0.679 |
| Tests in 180 days | 0.94 (0.91-0.96) | 0.27 (0.25-0.30) | 0.28 (0.26-0.31) | 0.93 (0.91-0.96) | 0.606 | 0.701 |
| Tests in 365 days | 0.99 (0.97-0.99) | 0.24 (0.21-0.26) | 0.28 (0.26-0.31) | 0.98 (0.96-0.99) | 0.611 | 0.709 |
| Tests between 21 and 60 days | 0.55 (0.50-0.60) | 0.70 (0.67-0.72) | 0.36 (0.32-0.40) | 0.84 (0.81-0.86) | 0.625 | 0.696 |
| Tests between 21 and 90 days | 0.69 (0.64-0.73) | 0.61 (0.58-0.64) | 0.35 (0.32-0.38) | 0.86 (0.84-0.89) | 0.649 | 0.715 |
| Tests between 21 and 180 days | 0.87 (0.83-0.90) | 0.48 (0.45-0.50) | 0.34 (0.31-0.37) | 0.92 (0.90-0.94) | 0.673 | 0.740 |
| Tests between 21 and 365 days | 0.97 (0.95-0.98) | 0.40 (0.37-0.42) | 0.33 (0.30-0.36) | 0.98 (0.96-0.99) | 0.683 | 0.755 |
| Two tests in 90 days | 0.61 (0.56-0.66) | 0.70 (0.67-0.72) | 0.38 (0.35-0.42) | 0.85 (0.83-0.87) | 0.654 | 0.715 |
| Two tests in 180 days | 0.82 (0.78-0.85) | 0.55 (0.52-0.58) | 0.36 (0.33-0.39) | 0.91 (0.89-0.93) | 0.683 | 0.743 |
| Two tests in 365 days | 0.94 (0.91-0.96) | 0.45 (0.43-0.48) | 0.35 (0.32-0.37) | 0.96 (0.94-0.97) | 0.696 | 0.762 |
| Two tests in 180 days, separated by 90 days | 0.59 (0.54-0.63) | 0.74 (0.71-0.76) | 0.41 (0.37-0.45) | 0.85 (0.83-0.87) | 0.632 | 0.758 |
| Two tests in 365 days, separated by 90 days | 0.90 (0.85-0.95) | 0.45 (0.43-0.47) | 0.38 (0.34-0.42) | 0.95 (0.93-0.97) | 0.721 | 0.780 |
Virologic suppression was defined as a HIV-1 RNA viral load less than 200 copies/ml, as the first viral load drawn between 366 days and 730 days after diagnosis. Visits refer to clinic visits for HIV care; i.e., an outpatient visit with a provider with prescribing privileges in an HIV care setting. Tests refer to laboratory tests sent, including CD4 T-cell counts and HIV-1 RNA levels. Either a CD4 T-cell count or HIV-1 RNA level was considered a laboratory test. Laboratory tests drawn on the same day were counted as one test. The date of the laboratory test was the date that the laboratory test was drawn, regardless of when it was entered into the database. Estimates are unadjusted estimates unless specified. Sensitivity for virologic suppression was defined as the proportion of those meeting the virologic suppression criteria who met the linkage criteria. Similarly, specificity for virologic suppression was defined as the proportion of those who did not achieve virologic suppression who did not meet the linkage criteria. PPV was defined as the proportion of those meeting linkage criteria who achieved virologic suppression, and NPV was defined as the proportion of those not meeting linkage criteria who did not achieve virologic suppression.
Adjusted for AIDS at time of diagnosis, race/ethnicity, exposure risk, gender, and age.
Abbreviations: PPV: Positive predictive value; NPV: negative predictive value; HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome; AUC: area under the curve