Timely linkage to HIV medical care has the potential to improve individual health outcomes and prevent secondary HIV transmission. Recent research found that estimates of delayed care entry varied by study design, with higher estimates among studies using only HIV case surveillance data. In this analysis, we compared the prevalence and risk factors for care delay using data from two studies with different designs conducted in New York City. The Medical Monitoring Project (MMP) used a retrospective design to estimate historical delay among persons currently receiving care, while the Never in Care (NIC) study used a prospective design to estimate current delay status among persons who were care-naive at baseline. Of 513 MMP subjects in 2007-2008, 23% had delayed care entry greater than three months after diagnosis. Independent risk factors for care delay were earlier year of diagnosis and testing positive in a nonmedical environment. Of 28 NIC subjects in 2008-2010, over half had tested positive in a nonmedical environment. The primary-stated reasons for delay were the same in both studies: denial of HIV status and lack of perceived need for medical care. The strengths and weaknesses of surveillance only, prospective, and retrospective study designs with respect to investigating this issue are explored. Future studies and interventions should be mindful of the common selection biases and measurement limitations with each design. A triangulation of estimates from varying designs is suggested for accurately measuring care linkage efforts over time.

This report presents data on participation in online or offline prevention activities among a sample of New York City men who have sex with men (MSM) recruited online between April-August of 2007 who use the Internet to meet sex partners. The analysis focuses on the 1,124 men who reported sex with a main or casual partner in the past 12 months. Over half (53%) of the MSM reported unprotected anal intercourse (UAI) in the past year. Data from our multivariate analysis indicate that MSM who participate in online or offline prevention activities were less likely to engage in UAI.

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BackgroundRetention of people with HIV (PWH) in HIV care is essential for optimal health outcomes. Unmet needs for ancillary services, such as housing, food, transportation, or mental health services may pose barriers to sustained retention in HIV care.MethodsA representative sample of people with HIV (PWH) aged ≥18 years and receiving HIV care in NYC between 2015 and 2016 was interviewed for the Medical Monitoring Project (MMP). Questions attempted to identify needs for ancillary services among participants. We explored correlates of expressed needs for ancillary services in the 12 months prior to the interview date.ResultsOf 654 PWH interviewed, 650 (99%) were current with HIV care. Of these, 323 (50%) expressed a need for ancillary services. Among the 323 PWH expressing needs, 209 (65%) were males, 163 (50%) were non-Hispanic blacks, 118 (37%) were Hispanic, and 111 (35%) were individuals identifying as gay (26%) or lesbian (9%).The median age was 50 [interquartile range (IQR) 40–58 years]. In the multivariate model, non-Hispanic blacks (OR: 2.5; 95% CI: 1.4, 4.6) and Hispanics (OR: 2.5; 95% CI: 1.4, 4.7) had higher odds than whites of expressing current needs for ancillary services. A higher need for ancillary services was expressed by PWH that were virally suppressed vs. not suppressed (OR: 1.7; 95% CI: 1.0, 3.0) and those with a history of injection drug use vs. those without (OR 2.2; 95% CI: 1.3, 3.7).ConclusionHalf of the PWH in our sample expressed a current need for ancillary services despite being actively engaged in HIV. Providers should routinely screen their patients, especially non-Hispanic black and Hispanic patients and persons with substance use history, for unmet needs and proactively link them to social service providers in order to promote overall well-being and retention in HIV care.Disclosures All authors: No reported disclosures.