Development of a Locator Tool and Protocol to Support People Living With HIV in Baltimore: A Quality Improvement Project

Retaining people with HIV (PWH) in medical care is crucial to ending HIV as an epidemic. Many PWH in Baltimore also experience high rates of substance use, mental health disorders, and homelessness, making it difficult to locate and engage them in care. In our hospital-to-community transitional care...

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Published inThe Journal of the Association of Nurses in AIDS Care
Main Authors Scott, Katherine, Moen, Marik, Hammersla, Marg, Doede, Megan
Format Journal Article
LanguageEnglish
Published United States 14.05.2025
Subjects
Online AccessGet full text
ISSN1055-3290
1552-6917
1552-6917
DOI10.1097/JNC.0000000000000562

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Abstract Retaining people with HIV (PWH) in medical care is crucial to ending HIV as an epidemic. Many PWH in Baltimore also experience high rates of substance use, mental health disorders, and homelessness, making it difficult to locate and engage them in care. In our hospital-to-community transitional care program for PWH, 50% of clients were lost to follow-up. To increase the percentage of engaged patients, we developed a locator tool and protocol detailing patient's social and personal information, to be used when clients could not otherwise be located. We obtained completed locator tools on 85% of our 20-client sample, and 76% of these were active at 60 days. Of these, 53% were active at 90 days. The locator tool and protocol were acceptable and feasible in locating and retaining hard-to-reach clients. Widespread, consistent use of the locator tool and protocol may be an effective intervention toward ending the HIV epidemic.
AbstractList Retaining people with HIV (PWH) in medical care is crucial to ending HIV as an epidemic. Many PWH in Baltimore also experience high rates of substance use, mental health disorders, and homelessness, making it difficult to locate and engage them in care. In our hospital-to-community transitional care program for PWH, 50% of clients were lost to follow-up. To increase the percentage of engaged patients, we developed a locator tool and protocol detailing patient's social and personal information, to be used when clients could not otherwise be located. We obtained completed locator tools on 85% of our 20-client sample, and 76% of these were active at 60 days. Of these, 53% were active at 90 days. The locator tool and protocol were acceptable and feasible in locating and retaining hard-to-reach clients. Widespread, consistent use of the locator tool and protocol may be an effective intervention toward ending the HIV epidemic.
Retaining people with HIV (PWH) in medical care is crucial to ending HIV as an epidemic. Many PWH in Baltimore also experience high rates of substance use, mental health disorders, and homelessness, making it difficult to locate and engage them in care. In our hospital-to-community transitional care program for PWH, 50% of clients were lost to follow-up. To increase the percentage of engaged patients, we developed a locator tool and protocol detailing patient's social and personal information, to be used when clients could not otherwise be located. We obtained completed locator tools on 85% of our 20-client sample, and 76% of these were active at 60 days. Of these, 53% were active at 90 days. The locator tool and protocol were acceptable and feasible in locating and retaining hard-to-reach clients. Widespread, consistent use of the locator tool and protocol may be an effective intervention toward ending the HIV epidemic.ABSTRACTRetaining people with HIV (PWH) in medical care is crucial to ending HIV as an epidemic. Many PWH in Baltimore also experience high rates of substance use, mental health disorders, and homelessness, making it difficult to locate and engage them in care. In our hospital-to-community transitional care program for PWH, 50% of clients were lost to follow-up. To increase the percentage of engaged patients, we developed a locator tool and protocol detailing patient's social and personal information, to be used when clients could not otherwise be located. We obtained completed locator tools on 85% of our 20-client sample, and 76% of these were active at 60 days. Of these, 53% were active at 90 days. The locator tool and protocol were acceptable and feasible in locating and retaining hard-to-reach clients. Widespread, consistent use of the locator tool and protocol may be an effective intervention toward ending the HIV epidemic.
Author Moen, Marik
Doede, Megan
Scott, Katherine
Hammersla, Marg
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Cites_doi 10.1080/09540121.2016.1226478
10.2105/AJPH.2015.302905
10.1016/j.jana.2013.06.004
10.5811/westjem.2016.6.30690
10.1111/hsc.12461
10.1016/j.trstmh.2011.02.011
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Keywords follow-up
HIV
locate
quality improvement
retention
Language English
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References Lam (R7-20250514) 2016; 17
Lamanna (R8-20250514) 2018; 26
Hirschman (R5-20250514) 2015; 20
Keller (R6-20250514) 2017; 29
Parker (R11-20250514) 2014; 25
Thomson (R12-20250514) 2011; 105
Aidala (R1-20250514) 2016; 106
References_xml – volume: 29
  start-page: 627
  issue: 5
  year: 2017
  ident: R6-20250514
  article-title: HIV patient retention: The implementation of a North Carolina clinic-based protocol
  publication-title: AIDS Care
  doi: 10.1080/09540121.2016.1226478
– volume: 20
  start-page: 1
  issue: 3
  year: 2015
  ident: R5-20250514
  article-title: Continuity of care: The Transitional Care Model
  publication-title: Online Journal of Issues in Nursing
– volume: 106
  start-page: e1
  issue: 1
  year: 2016
  ident: R1-20250514
  article-title: Housing status, medical care, and health outcomes among people living with HIV/AIDS: A systematic review
  publication-title: American Journal of Public Health
  doi: 10.2105/AJPH.2015.302905
– volume: 25
  start-page: 214
  issue: 3
  year: 2014
  ident: R11-20250514
  article-title: Differences in risk behaviors, care utilization, and comorbidities in homeless persons based on HIV status
  publication-title: The Journal of the Association of Nurses in AIDS Care
  doi: 10.1016/j.jana.2013.06.004
– volume: 17
  start-page: 607
  issue: 5
  year: 2016
  ident: R7-20250514
  article-title: Increased 30-day emergency department revisits among homeless patients with mental health conditions
  publication-title: The Western Journal of Emergency Medicine
  doi: 10.5811/westjem.2016.6.30690
– volume: 26
  start-page: 56
  issue: 1
  year: 2018
  ident: R8-20250514
  article-title: Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions
  publication-title: Health and Social Care in the Community
  doi: 10.1111/hsc.12461
– volume: 105
  start-page: 320
  issue: 6
  year: 2011
  ident: R12-20250514
  article-title: Implementation and outcomes of an active defaulter tracing system for HIV, prevention of mother to child transmission of HIV (PMTCT), and TB patients in Kibera, Nairobi, Kenya
  publication-title: Transactions of the Royal Society of Tropical Medicine and Hygiene
  doi: 10.1016/j.trstmh.2011.02.011
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Title Development of a Locator Tool and Protocol to Support People Living With HIV in Baltimore: A Quality Improvement Project
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