Assessing the Effectiveness of Data-to-Care Strategies for Improving HIV Care Outcomes: A Systematic Review.

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.