Evidence map›Paper›PMID 29465679›Full record

Trial reportSexually transmitted diseases2018

A Cluster Randomized Evaluation of a Health Department Data to Care Intervention Designed to Increase Engagement in HIV Care and Antiretroviral Use.

Julia C Dombrowski, James P Hughes, Susan E Buskin, Amy Bennett, David Katz, Mark Fleming, Angela Nunez, Matthew R Golden

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Sexually transmitted diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  14. The HIV Treat Pillar: An Update and Summary of Promising Approaches.American journal of preventive medicine · 2021
    Article
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  20. Public Health Practice-Driven Research to Improve HIV Prevention in the United States.Journal of acquired immune deficiency syndromes (1999) · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Julia C Dombrowski
James P HughesBiostatistics, University of Washington, Seattle, WA.
Susan E Buskin
Amy Bennett
David Katz
Mark FlemingPublic Health-Seattle & King County HIV/STD Program.
Angela NunezPublic Health-Seattle & King County HIV/STD Program.
Matthew R Golden

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI Judith Tsui · 1988 to 2026
$104.9M
Clinic and Population-Based Approaches to Retention in HIV CareK23MH090923 · NIMH · UNIVERSITY OF WASHINGTON · PI DOMBROWSKI, JULIA COOK · 2010 to 2014
$657k
NIAID NIH HHS P30 AI027757NIMH NIH HHS K23 MH090923NIMH NIH HHS L30 MH095060
6 · The paper itself

Abstract

backgroundMany US health departments have implemented Data to Care interventions, which use HIV surveillance data to identify persons who are inadequately engaged in HIV medical care and assist them with care reengagement, but the effectiveness of this strategy is uncertain.

methodsWe conducted a stepped-wedge, cluster-randomized evaluation of a Data to Care intervention in King County, Washington, 2011 to 2014. Persons diagnosed as having HIV for at least 6 months were eligible based on 1 of 2 criteria: (1) viral load (VL) greater than 500 copies/mL and CD4 less than 350 cells/μL at the last report in the past 12 months or (2) no CD4 or VL reported to the health department for at least 12 months. The intervention included medical provider contact, patient contact, and a structured individual interview. Health department staff assisted patients with reengagement using health systems navigation, brief counseling, and referral to support services. We clustered all eligible cases in the county by the last known medical provider and randomized the order of clusters for intervention, creating contemporaneous intervention and control periods (cases in later clusters contributed person-time to the control period at the same time that cases in earlier clusters contributed person-time to the intervention period). We compared the time to viral suppression (VL <200 copies/mL) for individuals during intervention and control periods using a Cox proportional hazards model.

resultsWe identified 997 persons (intention to treat [ITT]), 18% of whom had moved or died. Of the remaining 822 (modified ITT), 161 (20%) had an undetectable VL reported before contact and 164 (20%) completed the individual interview. The hazard ratio (HR) for time to viral suppression did not differ between the intervention and control periods in ITT (HR, 1.21 [95% confidence interval, 0.85-1.71]) or modified ITT (HR, 1.18 [95% confidence interval, 0.83-1.68]) analysis.

conclusionsThe Data to Care intervention did not impact time to viral suppression.

Indexed as

Patient ComplianceAdultAnti-Retroviral AgentsCD4 Lymphocyte CountCluster AnalysisEarly Medical InterventionFemaleHIV InfectionsHumansMaleMiddle AgedViral LoadWashingtonAnti-Retroviral Agents

Identifiers

PMID29465679
PMCPMC5948114

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.