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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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