Making HIV clinic appointments for clients with positive HIV results at testing sites can improve referral rates

Abstract

Background. The percentage of people living with undiagnosed HIV infection remains very high in Poland and exceeds 50%-one of the highest rates in Europe. At the same time, the number of HIV tests performed by medical doctors per 1,000 inhabitants is the lowest in Europe. Thus, every effort should be made to keep diagnosed patients in care. However, a number of patients are lost to care (LTC), with the percentage depending on the testing modality used (voluntary counseling and testing sites-VCTs, private laboratories, medical clinics, clubs) and communication skills of persons giving the results. Until now, there was only 1 prospective study in Poland that looked into the problem of continuum of care. Objectives. The objective of the study was to assess VCT clients' willingness to accept help with making the first appointment at a local HIV clinic after receiving positive results and the percentage of patients getting into care at the clinic after referral. Material and methods. Referral efficacy analysis between 2010 and 2014 was a joint venture between VCT site and the largest HIV clinic in Wrocław. Every patient diagnosed with HIV infection was offered personal help with making the first appointment at the HIV clinic. Later, it was assessed whether the first visit actually took place. Results. All the patients who collected their positive results came for their first visit at the HIV clinic with a referral rate reaching 100%, falling to 97. 1% only in 2013. Most visits took place during 1-2 weeks. Conclusions. Patients were willing to use counselors' help with making appointments at the HIV clinic, which in turn increased referral rates and numbers of patients retained in care.