Testing for comorbid conditions among people with HIV in medical care

Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services

Patient navigation is a primary element in linkage to HIV pre-exposure prophylaxis (PrEP) care and linkage to or re-engagement in HIV care, depending on the HIV status of the individual. However, there is a dearth of literature describing navigation services in these areas. In the context of Chicago Project PrIDE, this project conducted process and implementation evaluations with eight agencies leading demonstration projects to address these gaps. The evaluation team conducted semi-structured, individual interviews with agency staff (N = 20) assessing navigation implementation and fit, as well as project successes and challenges. Additionally, agency staff collected patient surveys (N = 300) assessing services provided, service quality, and satisfaction. The interview transcripts were coded and analyzed thematically and descriptive analyses were performed on the survey data. Analyses indicated that screening for social determinants of health, providing healthcare engagement guidance, and providing service referrals were frequently cited navigation activities. Most staff members indicated that navigation fits well within their agencies, and that limited staff and clinic capacity were often barriers to navigation. Patient navigation to support engagement in HIV prevention and care services is critical due to the extensive support provided by navigators to address social determinants of health impacting HIV disparity populations.

Population-based screening of hepatitis C virus in the United States

PURPOSE OF REVIEW

This review summarized the recent evidence on the performance of population-based hepatitis C virus (HCV) screening, published and indexed to PubMed, in the Unite States during the 2-year window from 1 January 2017 to 31 December 2018.

RECENT FINDINGS

A majority of the selected articles in this review focused on the birth cohort 1945-1965 because of the HCV screening recommendations released after August 2012. However, the articles for the high-risk population applied to all ages because the recommendations for this specific population have remained largely unchanged since 1998. The reported rates of HCV screening varied substantially not only across the three different populations (i.e. general, underserved, and high-risk) but also within each population.

SUMMARY

More vigilant monitoring of HCV screening performance of younger birth cohorts is needed as these individuals have been experiencing a higher incidence of HCV infection than those in the birth cohort 1945-1965. In addition, to meet the goal of eliminating HCV infection as a US public health problem by 2030, significant improvement in more accurately and comprehensively reporting the trends in population-based HCV screening across different populations is warranted in the future.