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J Acquir Immune Defic Syndr. 2015 Mar 1;68(3):304-9. doi: 10.1097/QAI.0000000000000459.

Location of HIV diagnosis impacts linkage to medical care.

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*Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; †Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; ‡Center for Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA; §Department of Medicine, Drexel University College of Medicine, Philadelphia, PA; ‖Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; and ¶Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA.


: We evaluated 1359 adults newly diagnosed with HIV in Philadelphia in 2010-2011 to determine if diagnosis site (medical clinic, inpatient setting, counseling and testing center (CTC), and correctional facility) impacted time to linkage to care (difference between date of diagnosis and first CD4/viral load). A total of 1093 patients (80%) linked to care: 86% diagnosed in medical clinics, 75% in inpatient settings, 62% in CTCs, and 44% in correctional facilities. Adjusting for other factors, diagnosis in inpatient settings, CTCs, and correctional facilities resulted in a 33% (adjusted hazard ratio = 0.77; 95% confidence interval: 0.64 to 0.92), 46% (0.56; 0.42-0.72), and 75% (0.25; 0.18-0.35) decrease in the probability of linkage compared with medical clinics, respectively.

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