1652. Equivalent HIV Outcomes for Persons with HIV after Re-engagement in HIV Care with Prior or New Provider

Abstract

BackgroundNew York City (NYC) health department staff assist people with HIV (PWH) deemed out of care (OOC) per NYC HIV Surveillance Registry to re-engage in HIV care with their last known treating provider/parent clinic or, if preferable/necessary (e.g., moved to a new neighborhood), a new NYC provider. We examined retention in care and viral suppression (VS) of PWH re-engaged in care in a group who agreed to return to care and were cared for by either their previous or a new provider.MethodsWe analyzed data from 2009 to 2015 on PWH who had ≥2 CD4 count or viral load (VL) test reports in the NYC HIV Registry who fell out of care and then re-engaged in care. We compared characteristics, timeliness and retention in care (≥2 CD4 or VL, ≥90 days apart) and VS (last VL ≤200 copies/mL) of PWH overall and also according to whether they returned to their last known vs. a new provider in year 2 post re-engagement in care.ResultsFrom 2009–2015, 882 persons were re-engaged in care by the health department. Most were diagnosed 5–10 (27%) or >10 (67%) years prior, and were OOC for 1–3 years (70%) or >3 years (20%). Most re-engaged PWH were male (63%), black (56%) or Hispanic (34%), US-born (79%), aged 30–49 (48%) or ≥50 (40%) years. Risk factors for HIV included heterosexual transmission (39%), male-sex-with-male (26%) or injection drug use (18%). Twenty-two percent had history of homelessness and 5% incarceration. Fifty-one percent and 49% re-engaged in care with their prior or a new provider, respectively. PWH re-engaged with prior providers vs. new providers had lower rates of prior or current homelessness (17% vs. 28%, P = 0.0001), PWH re-engaged to prior vs. new providers had their first lab reports and achieved VS earlier (1 vs. 2 months, and 4 vs. 5 months, respectively (both P < 0.05). Proportions of PWH re-engaged to prior or new providers and retained in care (92% vs. 91%, respectively) or with VS (73% vs. 75%, respectively) in year 2 did not differ.ConclusionOur results show that health department efforts to re-engage previously OOC-PWH in HIV care resulted in more than 70% achieving VS. Assignment to a new provider resulted in earlier VS but did not affect 2-year VS or care retention. PWH who re-engage in care can safely be given the choice between known or new providers.Disclosures All authors: No reported disclosures.