Location of HIV Diagnosis Impacts Linkage to Medical Care
ABSTRACT: We evaluated 1,359 adults newly diagnosed with HIV in Philadelphia in 2010-2011 to determine if diagnosis site (medical clinic, inpatient setting, counseling and testing center (CTC), correctional facility) impacted time to linkage to care (difference between date of diagnosis and first CD4/viral load). 1,093 patients (80%) linked to care: 86% diagnosed in medical clinics, 75% in inpatient settings, 62% in CTCs, and 44% in correctional facilities. Adjusting for other factors, diagnosis in inpatient settings, CTCs, and correctional facilities resulted in a 33% (adjusted hazard ratio=0.77, 95% confidence interval=0.64-0.92), 46% (0.56, 0.42-0.72), and 75% (0.25, 0.18-0.35) decrease in the probability of linkage compared to medical clinics, respectively.