Review Material Gardner Study Reprint

17_PIC_W3_GardnerReprintCarrier_Tool

Lytt I. Gardner, PhD
Highlights from

A Low-Effort, Clinic-Wide
Intervention Improves
Attendance for HIV
Primary Care

Retaining patients in HIV care can be improved
with coordinated messages to encourage clinic
attendance.
• During the first 3 months of the intervention year, 87.6% of 291

surveyed patients reported that a healthcare provider talked to them
about the importance of keeping all of their appointments.
• The intervention resulted in relative overall improvements in clinic

as published in Clinical Infectious Diseases

attendance that ranged from 7% for two consecutive appointments
kept to 3% based on the proportion of all appointments kept.

• Patients who enter treatment after a diagnosis of HIV infection must

remain in care to realize the full benefits of effective an­tiretroviral
therapy.

• Although as a percentage the impact of the intervention was relatively

small across all patients, the effect was highly significant compared with
the pre-intervention year.

• Improving retention of HIV-infected patients in care is a priority

from both clinical and public health perspectives and is a major objective
of the National HIV/AIDS Strategy.

• Subgroups with a doubled or greater intervention effect include new or

reengaging patients, patients with a detectable viral load, patients 16-29
years of age [see Table 2].

• CDC and HRSA jointly funded a two-phase, 5-year project to implement

interventions to retain patients in care. One interventional project
provided coordinated messages to encourage patients’ clinic attendance.
The enclosed article reports on the first phase (“Stay Connected”) of this
project.

• Although as a percentage the impact of the intervention was relatively

small across all patients, the effect was highly significant compared with
the pre-intervention year.
• Delivered at minimal effort and cost, targeted messages on staying

— Stay Connected is a clinic-wide intervention designed to retain patients in
HIV care using posters, brochures, and brief messages delivered by primary
care providers and other clinic staff. The intervention was conducted at six
HIV clinics in the US after clinic staff received standardized training.

in care were shown to improve clinic attendance, especially for new
or reengaging patients, patients with elevated viral loads, and young
patients.

— The intervention used targeted messages emphasizing the benefits of
staying in care. Providers were asked to deliver these very brief messages,
which could be worked into the routine of an HIV primary care visit.

• Retaining patients in HIV care can be improved with coordinated

messages to encourage clinic attendance.

Small Talks

Source: Gardner LI, Marks G, Craw JA, et al for the Retention in Care Study Group. A low-effort, clinic-wide intervention
improves attendance for HIV primary care. Clin Infect Dis. 2012;55:1124-1134.

Small Talks

IN HIV PRIMARY CARE
Care IS Prevention

IN HIV PRIMARY CARE
Care IS Prevention