Re-thinking Linkage to Care in the Era of Universal Test and Treat: Insights from Implementation and Behavioral Science for Achieving the Second 90.

To successfully link to care, persons living with HIV must negotiate a complex series of processes from HIV diagnosis through initial engagement with HIV care systems and providers. Despite the complexity involved, linkage to care is often oversimplified and portrayed as a single referral step. In t...

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Publicado en:AIDS & Behavior Vol. 23; pp. 120 - 129
Autores principales: Herce, Michael E., Chi, Benjamin H., Liao, Rodrigo C., Hoffmann, Christopher J.
Formato: review tables/charts Journal Article
Publicado: Springer Nature Sep2019 Suplement 2
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Re-thinking Linkage to Care in the Era of Universal Test and Treat: Insights from Implementation and Behavioral Science for Achieving the Second 90.
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          Herce, Michael E.
          Chi, Benjamin H.
          Liao, Rodrigo C.
          Hoffmann, Christopher J.
        affil: Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, 130 Mason Farm Rd. (Bioinformatics), 2nd floor, CB# 7030, 27599-7030, Chapel Hill, NC, USA
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        subj:
          Thinking
          Implementation Science
          Behavioral Sciences
          Achievement
          Conceptual Framework
          HIV Infections Therapy
          Health Services Accessibility
      ab:
        To successfully link to care, persons living with HIV must negotiate a complex series of processes from HIV diagnosis through initial engagement with HIV care systems and providers. Despite the complexity involved, linkage to care is often oversimplified and portrayed as a single referral step. In this article, we offer a new conceptual framework for linkage to care, tailored to the current universal test and treat era that presents linkage to care as its own nuanced pathway within the larger HIV care cascade. Conceptualizing linkage to care in this way may help better identify and specify processes posing a barrier to linkage, and allow for the development of targeted implementation and behavioral science-based approaches to address them. Such approaches are likely to be most relevant to programmatic and clinical settings with limited resources and high HIV burden.
        Resumen: Para vincularse a la atención médica con éxito, las personas que viven con VIH tienen que negociar una serie de pasos complicados desde el diagnóstico del VIH hasta las interacciones primeras con los sistemas y proveedores de cuidado y tratamiento del VIH. A pesar de la complejidad involucrada, muchas veces el vínculo con la atención médica es demasiado simplificado y se considera como un solo paso de remisión. En este artículo, ofrecemos una nueva definición operativa de la vinculación con la atención médica, adaptada a la era actual de prueba y tratamiento universal que establece la vinculación a la atención médica como su propio camino matizado dentro de la cascada más amplia del tratamiento de VIH. Conceptualizando la vinculación a la atención médica de esta manera puede ayudar a identificar y especificar mejor los procesos que dificulten la vinculación a la atención médica, y permitir el desarrollo de estrategias dirigidas y basadas en la ciencia de implementación y de compartamiento para abordar esos procesos obstructivos. Es probable que estas estrategias sean más relevantes para contextos programáticos y clínicos con recursos limitados y una alta prevalencia de VIH.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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