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CAPS Town Hall: Engaging and Keeping HIV Patients in Care
Slide Presentation
April 20, 2012
Katerina A. Christopoulos, MD, Assistant Adjunct Professor, UCSF
Elvin H. Geng, MD, MPH, Assistant Adjunct Professor, UCSF
Gabriel Chamie, MD, Assistant Adjunct Professor, UCSF

Click on slide thumbnails to view full-size image.

Slide 1.
CAPS Town Hall: Engaging and Keeping HIV Patients in Care
Slide 1.
National HIV/AIDS Strategy
Slide 2.
HRSA Continuum of Engagement
Slide 3.
Cyclical Nature of Engagement
Slide 4.
HIV Engagement in Care Cascade
Slide 5.
CDC Estimates of Engagement in Care
Slide 6.
Linkage and Retention
Slide 7.
Linkage
Slide 8.
Positive Health Access to Services and Treatment (PHAST)
Slide 9.
Possible Definitions of Linkage
Slide 10.
Characteristics of Patients Who Receive Rapid Tests for HIV in San Francisco General Hospital
Slide 11.
Linkage to Care for Patients Newly Diagnosed with HIV in the SFGH ED
Slide 12.
Appropriate Time Frame for Linkage?
Slide 13.
Strict & Less Strict Linkage Definitions
Slide 14.
Retention
Slide 15.
Importance of Retention
Slide 16.
Retention Measures (adapted from Mugavero et. al., AIDS Patient Care & STDs 2010)
Slide 17.
Comparing Different Measures
Slide 18.
Surveillance Data: The Denominator Problem
Slide 19.
Surveillance Data: The Tempo Problem
Slide 20.
Recent Recommendations on Measures
Slide 21.
What About the Patient Perspective?
Slide 22.
Patient Engagement And Retention/Linkage (PEARL)
Slide 23.
Patient Perspectives and the Cascade
Slide 24.
ED/Urgent Care Diagnosis Experience
Slide 25.
ED/Urgent Care Diagnosis Experience
Slide 26.
Linkage Experience
Slide 27.
Retention Experience
Slide 28.
Out of Care Experience
Slide 29.
Conclusions
Slide 30.
What Can (or Should) We Measure?
Slide 31.
What is "Effective" Engagement in Care?
Slide 32.
From Retention to Effectiveness
Slide 60.
Major Clinical Outcomes in ART
Slide 61.
Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival
Slide 62.
News Article on San Francisco HIV Policy
Slide 63.
Translating Policy into Action: The Ward 86 Experience
Slide 64.
Patients and Measurements
Slide 65.
Analyses
Slide 66.
Patients at the Ward 86 HIV/AIDS Clinic at San Francisco General Hospital, 2001-2011
Slide 67.
Average Individual HIV RNA Levels each Calendar Year, N=5,963
Slide 68.
Time from Clinic Entry to HIV RNA Suppression, N=2,546
Slide 69.
Mean HIV RNA Level by CD4 Level at Entry, N=2,546
Slide 70.
Factors Associated with HIV RNA Suppression Six Months afte Clinic Entry, N=2,546
Slide 71.
Time to HIV RNA Rebound from First HIV RNA < 500 c/ml, N=1,577
Slide 72.
Conclusions
Slide 73.
Implications
Slide 74.
CAPS Town Hall
Slide 33.
Study Objectives
Slide 34.
Campaign Procedures
Slide 35.
Community Campaign Profile
Slide 36.
CHC Sites: Kakyerere, Uganda
Slide 37.
Community Mobilization
Slide 38.
Campaign Staff Training
Slide 39.
Real Time Data Analysis
Slide 40.
Campaign Field Laboratory
Slide 41.
Image of the Setting
Slide 42.
Images of Participants
Slide 43.
Study Population
Slide 44.
Patient Transit Time Through Campaign
Slide 45.
HIV Prevalence
Slide 46.
HIV Prevalence by Age and Gender
Slide 47.
Prior HIV Testing and New Diagnoses
Slide 48.
CD4+ T cell Counts in Adults
Slide 49.
CD4+ Counts: Community Campaign vs. Clinic
Slide 50.
Fingerprick-Based Viral Load
Slide 51.
Community Viral Load
Slide 51.
Linkage to HIV Care
Slide 51.
Routine Referral to HIV Care
Slide 54.
Hypertension and Diabetes
Slide 55.
Linkage to Care - TB, HTN, DM
Slide 56.
Summary
Slide 57.
Thank you
Slide 58.
Thank you!
Slide 59.

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