Engaging patients in the HIV care continuum through referral-making behaviours and patterns: A descriptive cross-sectional study

Introduction: HIV continuum of care consists of five steps needed to effectively treat and prevent the spread of HIV. Linkage to and retention of patients to this Continuum of Care is a global priority. However, the COVID-19 pandemic has impacted the quality of this Continuum, as people living with HIV, have had to shelter reducing their access to services. As well, HIV agencies have had to close, reduce hours, and shift personnel. Purpose and Methods: The purpose of this descriptive cross-sectional study was to examine the person-centered referral-making behaviors and patterns used by providers to engage patients in the care continuum. Three classes of linkage behaviors among 285 providers in 34 community agencies in New York City were identified using latent class analysis. Results: These linkage behaviors include High (48%); Moderate (34%); and Low (18%). Both High and Moderate consisted of a blend of active and passive strategies and tracking systems. The High included more active strategies such as escorting patients to appointments. Linkage class membership was significantly associated with frequency of linkages to primary care (p=.020). COVID-19 disruptions demonstrate how the Care Continuum has been undermined by insufficient organizational resources. Conclusion: Findings suggest, addresses gaps in linkages should enhance the overall Continuum of Care provided to individuals diagnosed and living with HIV.