Yale University

Developing a Comprehensive Model of the HIV Care Continuum in Nine Small Cities in Connecticut, Massachusetts, and Rhode Island

Funder: National Institute of Mental Health
Project period: 07/01/2015 - 04/30/2016
Grant Type: Pilot Project

Abstract Text:

Since the HIV epidemic began over 30 years ago, over 50,000 HIV cases have been
diagnosed in Southern New England. While great strides have led to decreases in HIV
incidence in recent years, HIV prevalence continues to grow and thousands of people go
undiagnosed or are lost to follow-up and fall out of HIV care, jeopardizing their own health and the health of the larger community. The HIV Care Continuum (HCC) is a model that is used by local, state, and federal agencies and healthcare organizations to assess successes and failures in the delivery of treatment to people living with HIV (PLWH). It also informs healthcare officials and organizations about potential barriers and facilitators that can influence each step of the HCC. The model has been studied in large urban or metropolitan areas and less so in smaller cities where structural and sociodemographic factors as well as local resources can vary considerably and thereby decrease the applicability of HCC study findings from large urban regions. What little is known about the HCC in small U.S. cities is that (1) retention within the HCC can vary significantly across comparable small cities and (2) preliminary analyses point to differences that may be associated with individual, social, and structural factors. Several studies suggest that communities of color present for testing late in the course of their infection and have lower rates of retention in care and suppressed viral RNA. Using a mixed methods approach, we propose to gather and assess HCC-related data, in conjunction with geospatial and qualitative data, to begin to create a more comprehensive HCC model for nine small cities in Southern New England that can be used to identify successes and challenges along the HCC and facilitate development and testing of city-specific HIV interventions to improve success across the HCC.