Center for Public Health Systems Science, Brown School, Washington University in St. Louis, 1 Brookings Drive, Campus Box #1196, St. Louis, MO, 63130, USA.
Department of Biology, Vassar College, Poughkeepsie, NY, USA.
AIDS Behav. 2021 Mar;25(3):886-896. doi: 10.1007/s10461-020-03051-5. Epub 2020 Sep 30.
Evidence-based linkage to care interventions (LTCs) help recently diagnosed HIV+ individuals engage in care in a timely manner yet are heavily impacted by the systems in which they are embedded. We developed a prototype agent-based model informed by data from an established LTC program targeting youth and young adults aged 13-24 in Memphis, Tennessee. We then tested two interventions to improve LTC in a simulated environment: expanding testing sites versus using current testing sites but improving direct referral to LTC staff from organizations providing testing, to understand the impact on timely linkage to care. Improving direct referral to the LTC program decreased days to successful linkage from an average of 30 to 23 days but expanding testing sites increased average days to 31 days unless those sites also made direct referrals. We demonstrated how LTC is impacted by the system and interventions for shortening days to linkage to care.
循证联系护理干预（LTC）有助于新近诊断出 HIV 阳性的个体及时参与护理，但受到其所处系统的严重影响。我们开发了一个基于代理的原型模型，该模型基于田纳西州孟菲斯市一个针对 13-24 岁青年和年轻人的成熟 LTC 计划的数据。然后，我们在模拟环境中测试了两种改善 LTC 的干预措施：扩大检测点与利用当前检测点，但改善从提供检测的组织直接转介到 LTC 工作人员，以了解对及时联系护理的影响。改善直接转介到 LTC 计划将成功联系护理的天数从平均 30 天减少到 23 天，但如果这些站点没有直接转介，扩大检测点会将平均天数增加到 31 天。我们展示了 LTC 如何受到系统和缩短联系护理天数的干预措施的影响。
