From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs

Rebecca Metcalfe; Manon Ragonnet-Cronin; Amanda Bradley-Stewart; Andrew McAuley; Harrison Stubbs; Trina Ritchie; Regina O'Hara; Kirsten Trayner; Claire Glover; Lynn Laverty; Laura Sills; Kathryn Brown; Rory Gunson; John Campbell; Catriona Milsoevic; Patricia Anderson; S. Erica Peters

doi:10.1093/infdis/jiaa336

From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs

Rebecca Metcalfe^*, Manon Ragonnet-Cronin, Amanda Bradley-Stewart, Andrew McAuley, Harrison Stubbs, Trina Ritchie, Regina O'Hara, Kirsten Trayner, Claire Glover, Lynn Laverty, Laura Sills, Kathryn Brown, Rory Gunson, John Campbell, Catriona Milsoevic, Patricia Anderson, S. Erica Peters

^*Corresponding author for this work

SHLS School Office

Research output: Contribution to journal › Article

Abstract

An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

Original language	English
Pages (from-to)	S410-S419
Number of pages	10
Journal	Journal of Infectious Diseases
Volume	222
Issue number	Supplement_5
Early online date	2 Sep 2020
DOIs	https://doi.org/10.1093/infdis/jiaa336
Publication status	E-pub ahead of print - 2 Sep 2020

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10.1093/infdis/jiaa336

Metcalfe, R. et al (2020) From hospital to the community redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com DOI: 10.1093/infdis/jiaa336
Final published version, 1.4 MBLicence: CC BY-NC-ND

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Metcalfe, R., Ragonnet-Cronin, M., Bradley-Stewart, A., McAuley, A., Stubbs, H., Ritchie, T., O'Hara, R., Trayner, K., Glover, C., Laverty, L., Sills, L., Brown, K., Gunson, R., Campbell, J., Milsoevic, C., Anderson, P., & Peters, S. E. (2020). From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs. Journal of Infectious Diseases, 222(Supplement_5), S410-S419. https://doi.org/10.1093/infdis/jiaa336

Metcalfe, Rebecca ; Ragonnet-Cronin, Manon ; Bradley-Stewart, Amanda ; McAuley, Andrew ; Stubbs, Harrison ; Ritchie, Trina ; O'Hara, Regina ; Trayner, Kirsten ; Glover, Claire ; Laverty, Lynn ; Sills, Laura ; Brown, Kathryn ; Gunson, Rory ; Campbell, John ; Milsoevic, Catriona ; Anderson, Patricia ; Peters, S. Erica. / From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs. In: Journal of Infectious Diseases. 2020 ; Vol. 222, No. Supplement_5. pp. S410-S419.

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title = "From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs",

abstract = "An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.",

author = "Rebecca Metcalfe and Manon Ragonnet-Cronin and Amanda Bradley-Stewart and Andrew McAuley and Harrison Stubbs and Trina Ritchie and Regina O'Hara and Kirsten Trayner and Claire Glover and Lynn Laverty and Laura Sills and Kathryn Brown and Rory Gunson and John Campbell and Catriona Milsoevic and Patricia Anderson and Peters, {S. Erica}",

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Metcalfe, R, Ragonnet-Cronin, M, Bradley-Stewart, A, McAuley, A, Stubbs, H, Ritchie, T, O'Hara, R, Trayner, K, Glover, C, Laverty, L, Sills, L, Brown, K, Gunson, R, Campbell, J, Milsoevic, C, Anderson, P & Peters, SE 2020, 'From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs', Journal of Infectious Diseases, vol. 222, no. Supplement_5, pp. S410-S419. https://doi.org/10.1093/infdis/jiaa336

From hospital to the community: redesigning the Human Immunodeficiency Virus (HIV) clinical service model to respond to an outbreak of HIV among people who inject drugs. / Metcalfe, Rebecca; Ragonnet-Cronin, Manon; Bradley-Stewart, Amanda; McAuley, Andrew; Stubbs, Harrison; Ritchie, Trina; O'Hara, Regina; Trayner, Kirsten; Glover, Claire; Laverty, Lynn; Sills, Laura; Brown, Kathryn; Gunson, Rory; Campbell, John; Milsoevic, Catriona; Anderson, Patricia; Peters, S. Erica.

In: Journal of Infectious Diseases, Vol. 222, No. Supplement_5, 01.10.2020, p. S410-S419.

Research output: Contribution to journal › Article

TY - JOUR

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AU - Metcalfe, Rebecca

AU - Ragonnet-Cronin, Manon

AU - Bradley-Stewart, Amanda

AU - McAuley, Andrew

AU - Stubbs, Harrison

AU - Ritchie, Trina

AU - O'Hara, Regina

AU - Trayner, Kirsten

AU - Glover, Claire

AU - Laverty, Lynn

AU - Sills, Laura

AU - Brown, Kathryn

AU - Gunson, Rory

AU - Campbell, John

AU - Milsoevic, Catriona

AU - Anderson, Patricia

AU - Peters, S. Erica

N1 - Acceptance in SAN OA journal © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

PY - 2020/9/2

Y1 - 2020/9/2

N2 - An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

AB - An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

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