XIX International AIDS Conference

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TUPE768 - Poster Exhibition


The need for HIV care linkage through syringe exchange in Baltimore, Maryland

J. Han1, C. Serio-Chapman1, S. Sherman2, P. Chaulk3

1Baltimore City Health Department, Community Risk Reduction Services, Baltimore, United States, 2Johns Hopkins Bloomberg School of Public Health, Epidemiology, Baltimore, United States, 3Baltimore City Health Department, Baltimore, United States

Background: Syringe exchange programs (SEPs) are cost-effective and evidence-based interventions that not only reduce HIV and Hepatitis virus transmission, but also can serve as a bridge to medical care and drug treatment. There is a dearth of literature examining the role of SEPs in linking injection drug users (IDUs) to HIV care. The current study aims to examine the prevalence of HIV and entry into care among clients of the Baltimore City Health Department (BCHD) run SEP.
Methods: During 2011, there were 1,251 IDUs who had visited SEP at least once. As the only confidential SEP in the U.S., it was therefore possible to obtain HIV testing and care data for SEP clients from BCHD's internal databases. Recent HIV testing and HIV care were defined as having been tested or visiting an HIV care provider at least once within the past year.
Results: SEP clients were primarily male (65.8%) and Black (59.2%) with an average age of 43.2 years. The median number of SEP visits per client per year and number of syringes distributed/returned was 4 and 80, respectively. Of the 196 SEP clients who tested for HIV in 2011, 13.8% were positive. The overall HIV prevalence for clients was 12.2% (n=153) and only 27.5% of them have received HIV care in the past 12 months. 72.5% need to be referred to Ryan White for additional follow-up and possible re-linkage to care.
Conclusions: This study demonstrates that there is a high prevalence of HIV among Baltimore SEP clients and a low proportion of them are receiving HIV care. Based on these findings, BCHD SEP is developing a specific strategy for a better HIV care linkage process that would not only increase access but also improve continuity of HIV care among IDUs.

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