the missing link in test-and-treat identifying and improving gaps in care
DESCRIPTION
The Missing Link in Test-and-Treat identifying and improving gaps in care. test. treat. Sophy Wong, MD Medical Director, East Bay AETC Medical Director, HIV ACCESS Internist and HIV specialist, Asian Health Services Assistant Clinical Professor of Medicine, UCSF. disclosures. None! - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/1.jpg)
The Missing Link in Test-and-Treatidentifying and improving gaps in care
Sophy Wong, MDMedical Director, East Bay AETC
Medical Director, HIV ACCESSInternist and HIV specialist, Asian Health Services
Assistant Clinical Professor of Medicine, UCSF
testtreat
![Page 2: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/2.jpg)
disclosures
None!
I have no financial arrangements or affiliations with commercial interests.
Commercial support was not received for this activity.
I will not discuss off-label uses of drugs or products in my presentation.
![Page 3: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/3.jpg)
objectives
1. Describe the impact of using clinical data, especially linkage rates, retention rates and viral loads on test-and-treat outcomes.
2. Identify and analyze gaps in linkage to and retention in care.
3. Propose a work plan to implement at least one strategy for identifying and/or improving linkage and retention rates.
![Page 4: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/4.jpg)
workshop format
• Gardner & CDC test-link-treat cascades• Case• Definitions of linkage, retention, and viral
load suppression• The Alameda County experience• How to use this data to improve care• Your experience and way forward!
![Page 5: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/5.jpg)
80%62%
41% 36%28%
2011-11-29 MMWR 60
![Page 6: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/6.jpg)
New HIV infections
Access to care: test & treat!
HIV health disparities
![Page 7: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/7.jpg)
treatment reduces transmission by
96%
![Page 8: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/8.jpg)
65%
85%
79%
90%
73%
80%
28%
48%
NHAS Goals
![Page 9: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/9.jpg)
case
A 28 year old African American bisexual man tests positive at a community-based rapid testing project…
![Page 10: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/10.jpg)
2011-11-29 MMWR 60
![Page 11: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/11.jpg)
% diagnosed % engaged % ART % VL <200
79%
41%36%
28%
79%
37%33%
28%
Test - Link - TreatNational HIV ACCESS
![Page 12: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/12.jpg)
Definitions
• Linkage: how does the CDC define linkage to care?
• Retention: how does HRSA define retention in care?
![Page 13: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/13.jpg)
% diagnosed % engaged % ART % VL <200
79%
41%36%
28%
79%
37%33%
28%
Test - Link - TreatNational HIV ACCESS
![Page 14: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/14.jpg)
% diagnosed % engaged % ART % VL <200
79%
41%36%
28%
79%
37%33%
28%
Test - Link - TreatNational HIV ACCESS
![Page 15: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/15.jpg)
Definitions
Viral load suppression: how does the CDC define viral load suppression?
![Page 16: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/16.jpg)
% diagnosed % engaged % ART % VL <200
79%
41%36%
28%
79%
37%33%
28%
Test - Link - TreatNational HIV ACCESS
![Page 17: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/17.jpg)
The Missing Link in Test-and-Treat
testtreat
link
![Page 18: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/18.jpg)
The Missing Link: Linkage & retention is our weakest point.
![Page 19: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/19.jpg)
So what?
![Page 20: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/20.jpg)
What will it take to substantially reduce HIV transmission in an entire population?
Gardner, CID 2011
Answer: Treatment AND Prevention
![Page 21: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/21.jpg)
![Page 22: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/22.jpg)
Questions?
![Page 23: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/23.jpg)
CME / CE credits
If you would like to receive continuing education credit for this activity, visit:
http://www.pesgce.com/RyanWhite2012
![Page 24: The Missing Link in Test-and-Treat identifying and improving gaps in care](https://reader036.vdocument.in/reader036/viewer/2022062323/5681665f550346895dd9e77a/html5/thumbnails/24.jpg)
thanks!AETC:Kathleen ClanonEast Bay AETC team
OAA/DPH HIV data team:Lorenzo HinojosaNeena MurgaiKate BuchaczElaine BautistaAlex Marr
Kaiser: Leo HurleyHighland: Doug WhiteAHS: Koji SakakibaraEBAC Downtown Youth Clinic
HIV ACCESS:Lois LindseyDan ClanonJose ReyesBrianna Rogan
Alameda County DPH:Damon Francis
Office of AIDS:Kabir Hypolite
CA State:Mark DamesynMatt Facer