Table 3.
Enrollment in and outcomes of navigation and other linkage, reengagement, and retention (NLRR) programs for people with HIV, by enrollee characteristics, at 8 Care and Prevention in the United States (CAPUS) Demonstration Project sites, 2012-2016a
| Demographic and Behavioral Risk Characteristics | Total Enrollees in NLRR Programs,b No. (%) | Enrollees Who Were Never in Care | Enrollees Who Were Previously in Care | Enrollees Who Entered or Reentered Care | |||
|---|---|---|---|---|---|---|---|
| Enrolled in Linkage Activity,c No. (% of Total)d | Linked to Care, No. (% of Enrolled in Linkage Activity)e [P Value]f | Enrolled in Reengagement Activity,g No. (% of Total)d | Reengaged With Care, No. (% of Enrolled in Reengagement Activity)e [P Value]f | Enrolled in Retention- in-Care Support Activity,h No. (% of Total)d | Enrolled in Medication Adherence Support Activity,h No. (% of Total)d | ||
| Race/ethnicity | |||||||
| Latino | 527 (5.1) | 138 (26.2) | 97 (70.3) [.15] | 168 (31.9) | 119 (70.8) [.46] | 266 (50.5) | 192 (36.4) |
| Non-Hispanic black | 7656 (73.7) | 1620 (21.2) | 1291 (79.7) [.13] | 3661 (47.8) | 2883 (78.7) [.002] | 3205 (41.9) | 3210 (41.9) |
| Non-Hispanic white | 1886 (18.2) | 461 (24.4) | 352 (76.4) [Ref.] | 795 (42.2) | 585 (73.6) [Ref.] | 1041 (55.2) | 868 (46.0) |
| Non-Hispanic other/unknown | 313 (3.0) | 64 (20.4) | 36 (56.3) [.001] | 110 (35.1) | 62 (56.4) [<.001] | 113 (36.1) | 126 (40.3) |
| Gender | |||||||
| Male | 7641 (73.6) | 1698 (22.2) | 1385 (81.6) [<.001] | 3636 (47.6) | 2810 (77.3) [.84] | 3351 (43.9) | 3319 (43.4) |
| Female | 2494 (24.0) | 516 (20.7) | 345 (66.9) [Ref.] | 1017 (40.8) | 789 (77.6) [Ref.] | 1176 (47.2) | 1022 (41.0) |
| Transgender | 213 (2.1) | 65 (30.5) | 44 (67.7) [.90] | 75 (35.2) | 50 (66.7) [.03] | 94 (44.1) | 52 (24.4) |
| Other/unknown | 34 (0.3) | 4 (11.8) | 2 (50.0) [.001] | 6 (17.6) | 0 [<.001] | 4 (11.8) | 3 (8.8) |
| HIV risk category | |||||||
| MSM | 4829 (46.5) | 1194 (24.7) | 1072 (89.8) [<.001] | 1988 (41.2) | 1603 (80.6) [<.001] | 2279 (47.2) | 1780 (36.9) |
| PWID | 416 (4.0) | 55 (13.2) | 42 (76.4) [.92] | 172 (41.3) | 130 (75.6) [.41] | 197 (47.4) | 148 (35.6) |
| High-risk heterosexuali | 3023 (29.1) | 627 (20.7) | 483 (77.0) [Ref.] | 1475 (48.8) | 1035 (70.2) [Ref.] | 1213 (40.1) | 1337 (44.2) |
| MSM/PWID | 239 (2.3) | 23 (9.6) | 21 (91.3) [.11] | 75 (31.4) | 58 (77.3) [.19] | 163 (68.2) | 84 (35.1) |
| Other/unknown | 1875 (18.1) | 384 (20.5) | 158 (41.1) [<.001] | 1024 (54.6) | 823 (80.4) [<.001] | 773 (41.2) | 1047 (55.8) |
| Total | 10 382 (100.0) | 2283 (22.0) | 1776 (77.8) | 4734 (45.6) | 3649 (77.1) | 4625 (44.5) | 4396 (42.3) |
Abbreviations: MSM, men who have sex with men; PWID, people who inject drugs; ref, reference group.
aCAPUS was a 4-year cross-agency demonstration project led by the Centers for Disease Control and Prevention with the aim of reducing HIV/AIDS-related morbidity and mortality among racial/ethnic minority groups in the United States. Eight states (Georgia, Illinois, Louisiana, Mississippi, Missouri, North Carolina, Tennessee, and Virginia) received funding to implement the project.8
bEnrollment is broadly defined to include any level of contact or engagement in a CAPUS-supported program intended to provide services, including intake interviews, screening or needs assessments, referral and navigation services, or a combination of these activities. Total enrollees in NLRR programs include the number of unique people who were contacted or engaged through intake assessment, screening or needs assessment, referral, linkage or navigation to services, or a combination of similar activities. Follow-up data on medication adherence and retention in care were not collected because of concerns about data burden.
cLinkage-to-care program enrollees include only those with HIV who were never in care.
dThe denominator for percentage of those enrolled in activities designed to facilitate linkage to or reengagement with care, retention in care, or medication adherence was the total number of NLRR enrollees.
eThe denominators for the percentages of those linked to and reengaged with care were the number of those who were enrolled in a linkage or reengagement activity, respectively. People with diagnosed HIV are considered linked to or reengaged with care if they had attended their first HIV medical appointment ever or after being out of care for at least the past 6 months, respectively. Linkage or reengagement could also be confirmed by a documented viral load test or CD4 count.
fWithin-group comparisons on linkage and reengagement rates were conducted using a Z test for proportions. Non-Hispanic white was the reference group for race/ethnicity, female was the reference group for gender, and high-risk heterosexual was the reference group for HIV transmission risk.
gReengagement with care program enrollees include only those who had fallen out of care.
hRetention in care and medication adherence support activity enrollees include those who were entering or reentering care through NLRR programs.
iHigh-risk heterosexual includes people who report heterosexual contact and 1 or more sexual risk behaviors, such as condomless sex, sex with people with HIV, sex while high or intoxicated, exchange of sex for drugs or money, sex with anonymous partners, or sex with multiple partners.