Brief Case Management Intervention Links HIV-Infected Persons to Care

Lytt I. Gardner at CDC and fellow members of the Antiretroviral Treatment and Access Study group assessed a case management intervention to improve linkage to care for persons recently diagnosed with HIV. Participants in Atlanta, Baltimore, Los Angeles, and Miami were randomly assigned "to either standard of care (SOC) passive referral or case management (CM) for linkage to nearby HIV clinics. The SOC arm received information about HIV and local care resources; the CM intervention arm included up to five contacts with a case manager over a 90-day period. The outcome measure was self-reported attendance at an HIV care clinic at least twice over a 12-month period," the researchers reported.

"A higher proportion of the 136 case-managed participants than the 137 SOC participants visited an HIV clinician at least once within 6 months (78 vs. 60 percent; adjusted relative risk (RRadj), 1.36; p=0.0005) and at least twice within 12 months (64 vs. 49 percent; RRadj, 1.41; p=0.006)," according to the study. "Individuals older than 40 years, Hispanic participants, individuals enrolled within 6 months of an HIV-seropositive test result, and participants without recent crack cocaine use were all significantly more likely to have made two visits to an HIV care provider."

The investigators estimated the cost of case management to be $600-$1200 per client. "A brief intervention by a case manager was associated with a significantly higher rate of successful linkage to HIV care. Brief case management is an affordable and effective resource that can be offered to HIV-infected clients soon after their HIV diagnosis," the researchers concluded.

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