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Author Notes:

Correspondence to Andres F. Camacho-Gonzalez, MD, MSc, Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Dr Suite 500, Atlanta, GA 30322, USA. Tel: +1 404 727 5642; fax: +1 404 727 9223; e-mail: acamac2@emory.edu

All authors reviewed the final submitted manuscript and gave their approval. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

See publication for full list of contributions.

The authors will like to acknowledge our community partners AIDS Healthcare Foundation, AID Atlanta and Positive Impact, the Fulton County Department of Health and Wellness and the LGTBQ unit of the Atlanta Police Department.

These data were presented in part at the National HIV Prevention Conference, Atlanta, Georgia, December 2015 and at the Conference of Retroviruses and Opportunistic Infections, Seattle Washington, February 2017.

The findings and conclusions in the paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

There are no conflicts of interest.

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Research Funding:

The work was supported by the Centers for Disease Control and Prevention, grant number 5U01PS003322, the National Center for Advancing Translational Sciences of the National Institutes of Health under Award number UL1TR000454 and by the Center for AIDS Research At Emory University (P30AI050409).

A.F.C.-G. has received research support from Gilead and Janssen Pharmaceuticals. R.C. has received research support from Gilead.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • Virology
  • HIV testing
  • linkage in care
  • retention in care
  • youth
  • UNITED-STATES
  • ANTIRETROVIRAL THERAPY
  • YOUNG-ADULTS
  • INFECTED ADOLESCENTS
  • HEALTH
  • RETENTION
  • SEX
  • TRANSMISSION
  • PREDICTORS
  • ENGAGEMENT

The Metropolitan Atlanta community adolescent rapid testing initiative study: closing the gaps in HIV care among youth in Atlanta, Georgia, USA

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Journal Title:

AIDS

Volume:

Volume 31

Publisher:

, Pages S267-S275

Type of Work:

Article | Final Publisher PDF

Abstract:

Published by Wolters Kluwer Health, Inc. Objective: To determine the effectiveness of the Metropolitan Atlanta community adolescent rapid testing initiative (MACARTI) intervention relative to standard of care (SOC), in achieving early diagnosis, linkage, and retention among HIV-infected youth ages 18-24 years. Design: MACARTI was a pilot single-center, prospective, nonrandomized study. Methods: MACARTI combined nontraditional venue HIV testing, motivational interviewing, and case management. We collected demographic, clinical variables and calculated linkage and appointment adherence rates. We obtained SOC data from an adolescent HIV clinic. Longitudinal data were analyzed using inverse propensity treatment-weighted linear growth models; medians, interquartile ranges (IQR), means, and 95% confidence intervals are provided. Results: MACARTI screened 435 participants and identified 49 (11.3%) HIV infections. The SOC arm enrolled 49 new HIV-infected individuals. The 98 participants, (49 in each arm) were: 85% men; 91% Black; mean age = 21 years (SD: 1.8). Overall, 63% were linked within 3 months of diagnosis; linkage was higher for MACARTI compared to SOC (96 vs. 57%, P < 0.001). Median linkage time for MACARTI participants compared to SOC was 0.39 (IQR: 0.20-0.72) vs. 1.77 (IQR: 1.12-12.65) months (P < 0.001). MACARTI appointment adherence was higher than SOC (86.1 vs. 77.2%, P = 0.018). In weight-adjusted models, mean CD4 + T-cell counts increased and mean HIV-1 RNA levels decreased in both arms over 12 months, but the differences were more pronounced in the MACARTI arm. Conclusion: MACARTI successfully identified and linked HIV-infected youth in Atlanta, USA. MACARTI may serve as an effective linkage and care model for clinics serving HIV-infected youth.

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© 2017 The Author(s).

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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