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 -