Roberts Kristin Tansil, Mullins Mary, Higa Darrel H, Koenig Linda J, Mallett Megan, Wichser Megan, Denard Christa L, Gunn Jayleen, Nji Miriam A M, Nguyen Briana, Mitchell Janae, Pontes Miya, Underwood Madison, Sipe Theresa Ann
Translation and Evaluation Branch, Division of HIV Prevention, The U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop US8-5, Atlanta, GA, 30329, USA.
Office of the Director, Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
AIDS Behav. 2025 Jul 16. doi: 10.1007/s10461-025-04768-x.
Data-to-Care (D2C) is a strategy that uses HIV surveillance data or other data sources to identify out-of-care (OOC) persons with HIV (PWH) and link or re-engage them in care to improve viral suppression (VS). While some evidence suggests D2C is effective, no comprehensive systematic review has been published. This review aims to determine the effectiveness of D2C. A systematic search in five databases (i.e., MEDLINE, EMBASE, PsycINFO, CINAHL, sociological abstracts) identified 3868 U.S. studies published between January 2009 and January 2021 that described D2C interventions and measured HIV care outcomes. Two reviewers screened titles/abstracts, reviewed full reports for eligibility, and abstracted data. Risk of bias was assessed using the Mixed Methods Appraisal Tool, and included studies were synthesized quantitatively and qualitatively (Protocol registered on PROSPERO ID = CRD42020173095). Thirty-four studies with 30 unique interventions were identified. Two different meta-analyses, each with six interventions, found that D2C approached significance in improving engagement in care (Relative Risk (RR) 95% CI 1.18 [0.99 to 1.41]) and VS (RR 95% CI 1.44 [0.99 to 2.09]). Studies that could not be incorporated into the meta-analyses, also showed improvements in engagement in care (median percent [IQI]: 63% [45% to 81%], 18 interventions) and VS (median percent [IQI]: 39% [25% to 57%], 14 interventions). Overall, this systematic review suggests that D2C may enhance HIV care outcomes, emphasizing the need for effective strategies to identify and engage OOC persons in care.
数据到关怀（D2C）是一种利用艾滋病毒监测数据或其他数据源来识别未接受治疗的艾滋病毒感染者（PWH），并使他们获得或重新获得治疗以提高病毒抑制（VS）的策略。虽然一些证据表明D2C是有效的，但尚未发表全面的系统评价。本评价旨在确定D2C的有效性。在五个数据库（即MEDLINE、EMBASE、PsycINFO、CINAHL、社会学文摘）中进行的系统检索，确定了2009年1月至2021年1月期间发表的3868项美国研究，这些研究描述了D2C干预措施并测量了艾滋病毒治疗结果。两名评审员筛选标题/摘要，审查完整报告的资格，并提取数据。使用混合方法评估工具评估偏倚风险，纳入的研究进行了定量和定性综合分析（方案在PROSPERO ID=CRD42020173095上注册）。确定了34项研究，有30种独特的干预措施。两项不同的荟萃分析，每项有六种干预措施，发现D2C在改善治疗参与度（相对风险（RR）95%CI 1.18[0.99至1.41]）和病毒抑制（RR 95%CI 1.44[0.99至2.09]）方面接近显著水平。无法纳入荟萃分析的研究也显示治疗参与度有所改善（中位数百分比[四分位间距]：63%[45%至81%]，18项干预措施）和病毒抑制（中位数百分比[四分位间距]：39%[25%至57%]，14项干预措施）。总体而言，这项系统评价表明D2C可能会改善艾滋病毒治疗结果，强调需要有效的策略来识别未接受治疗的人并使其获得治疗。
