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The Missing Link in Test-and-Treat identifying and improving gaps in care. test. treat. Sophy Wong, MD Medical Director, East Bay AETC Medical Director, HIV ACCESS Internist and HIV specialist, Asian Health Services Assistant Clinical Professor of Medicine, UCSF. disclosures. None!

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The Missing Link in Test-and-Treat identifying and improving gaps in care


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    1. The Missing Link in Test-and-Treatidentifying and improving gaps in care test treat Sophy Wong, MD Medical Director, East Bay AETC Medical Director, HIV ACCESSInternist and HIV specialist, Asian Health ServicesAssistant Clinical Professor of Medicine, UCSF

    2. disclosures None! I have no financial arrangements or affiliations with commercial interests. Commercial support was not received for this activity. I will not discuss off-label uses of drugs or products in my presentation.

    3. objectives • Describe the impact of using clinical data, especially linkage rates, retention rates and viral loads on test-and-treat outcomes. • Identify and analyze gaps in linkage to and retention in care. • Propose a work plan to implement at least one strategy for identifying and/or improving linkage and retention rates.

    4. workshop format • Gardner & CDC test-link-treat cascades • Case • Definitions of linkage, retention, and viral load suppression • The Alameda County experience • How to use this data to improve care • Your experience and way forward!

    5. 80% 62% 41% 36% 28% 2011-11-29 MMWR 60

    6. New HIV infections • Access to care: test & treat! •  HIV health disparities

    7. treatment reduces transmission by 96%

    8. NHAS Goals 79%  90% 65%  85% 73%  80% 28%  48%

    9. case A 28 year old African American bisexual man tests positive at a community-based rapid testing project…

    10. 2011-11-29 MMWR 60

    11. Definitions • Linkage: how does the CDC define linkage to care? • Retention: how does HRSA define retention in care?

    12. Definitions Viral load suppression: how does the CDC define viral load suppression?

    13. The Missing Link in Test-and-Treat test treat link

    14. The Missing Link: Linkage & retention is our weakest point.

    15. So what?

    16. What will it take to substantially reduce HIV transmission in an entire population? Answer: Treatment AND Prevention Gardner, CID 2011

    17. Questions?

    18. CME / CE credits If you would like to receivecontinuingeducationcreditforthisactivity, visit: http://www.pesgce.com/RyanWhite2012

    19. thanks! AETC: Kathleen Clanon East Bay AETC team OAA/DPH HIV data team: Lorenzo Hinojosa Neena Murgai Kate Buchacz Elaine Bautista Alex Marr Kaiser: Leo Hurley Highland: Doug White AHS: Koji Sakakibara EBAC Downtown Youth Clinic HIV ACCESS: Lois LindseyDan Clanon Jose Reyes Brianna Rogan Alameda County DPH: Damon Francis Office of AIDS: KabirHypolite CA State: Mark Damesyn Matt Facer