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 › peer-review

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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	Published - 1 Oct 2020

Keywords

Antirheumatic Agents/therapeutic use
Community Health Services/methods
Contact Tracing/methods
Disease Outbreaks/prevention & control
Female
HIV Infections/drug therapy
HIV Testing/methods
HIV/genetics
Homeless Persons
Humans
Male
Medication Adherence
Models, Organizational
Nurses/organization & administration
Pharmacies/organization & administration
Phylogeny
Scotland/epidemiology
Substance Abuse, Intravenous/complications
Viral Load

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Documents and Links

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

Cite this

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

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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.",

keywords = "Antirheumatic Agents/therapeutic use, Community Health Services/methods, Contact Tracing/methods, Disease Outbreaks/prevention & control, Female, HIV Infections/drug therapy, HIV Testing/methods, HIV/genetics, Homeless Persons, Humans, Male, Medication Adherence, Models, Organizational, Nurses/organization & administration, Pharmacies/organization & administration, Phylogeny, Scotland/epidemiology, Substance Abuse, Intravenous/complications, Viral Load",

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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month = oct,

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doi = "10.1093/infdis/jiaa336",

language = "English",

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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 et al.

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

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

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 - 2020/10/1

Y1 - 2020/10/1

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.

KW - Antirheumatic Agents/therapeutic use

KW - Community Health Services/methods

KW - Contact Tracing/methods

KW - Disease Outbreaks/prevention & control

KW - Female

KW - HIV Infections/drug therapy

KW - HIV Testing/methods

KW - HIV/genetics

KW - Homeless Persons

KW - Humans

KW - Male

KW - Medication Adherence

KW - Models, Organizational

KW - Nurses/organization & administration

KW - Pharmacies/organization & administration

KW - Phylogeny

KW - Scotland/epidemiology

KW - Substance Abuse, Intravenous/complications

KW - Viral Load

U2 - 10.1093/infdis/jiaa336

DO - 10.1093/infdis/jiaa336

M3 - Article

C2 - 32877546

VL - 222

SP - S410-S419

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - Supplement_5

ER -

Metcalfe R, Ragonnet-Cronin M, Bradley-Stewart A, McAuley A, Stubbs H, Ritchie T et al. 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. 2020 Oct 1;222(Supplement_5):S410-S419. Epub 2020 Sep 2. 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

Abstract

Keywords

UN SDGs

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