{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T03:52:01Z","timestamp":1782532321657,"version":"3.54.5"},"reference-count":44,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Retention in HIV care and viral suppression rates remain suboptimal, especially among people with HIV (PWH) facing complex barriers to care such as mental health conditions, substance use disorders, and housing insecurity. The Center for Adherence, Retention, and Engagement Support (CARES) program utilizes an interdisciplinary team that delivers integrated services in a drop-in setting to provide individualized care to PWH with complex psychosocial needs. We describe the CARES program and evaluate its effectiveness in retaining patients in care to achieve virological suppression. We characterized 119 referrals of PWH experiencing homelessness, mental health conditions, and substance use disorders to CARES between 2011 and 2017, and collected data for a 24-month observation period through 2019. Outcomes of patients who participated in CARES were compared with those who were referred but did not participate. The primary outcome was viral suppression (&lt;200 copies\/mL) at least once during 2-year follow-up. Retention in care (\u22652 completed medical visits \u226590 days apart in each year post-referral) was a secondary outcome. Of 119 PWH referred to CARES, 59 participated with \u22652 visits. Those who participated in CARES were more likely to achieve viral suppression [adjusted odds ratio (aOR) 3.50, 95% confidence interval (CI) 1.19\u201310.32] and to be retained in care (aOR 3.73, 95% CI 1.52\u20139.14) compared with those who were referred but did not participate. This analysis found that the CARES program improved retention in care and viral suppression among PWH with complex psychosocial needs and suggests that it may represent a useful model for future programming.<\/jats:p>","DOI":"10.1089\/apc.2023.0061","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T12:23:31Z","timestamp":1691756611000},"page":"416-424","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["The CARES Program: Improving Viral Suppression and Retention in Care Through a Comprehensive Team-Based Approach to Care for People with HIV and Complex Psychosocial Needs"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4567-5920","authenticated-orcid":false,"given":"Stephanie","family":"Sweitzer","sequence":"first","affiliation":[{"name":"J. Willis Hurst Internal Medicine Residency Program, Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddie","family":"Giegold","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyun","family":"Chen","sequence":"additional","affiliation":[{"name":"Biostatistics and Informatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene W.","family":"Farber","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA."},{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeri","family":"Sumitani","sequence":"additional","affiliation":[{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arkeelaua","family":"Henderson","sequence":"additional","affiliation":[{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk","family":"Easley","sequence":"additional","affiliation":[{"name":"Biostatistics and Informatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy S.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."},{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Colasanti","sequence":"additional","affiliation":[{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."},{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA."},{"name":"Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel J.","family":"Ammirati","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA."},{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent C.","family":"Marconi","sequence":"additional","affiliation":[{"name":"Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA."},{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA."},{"name":"Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA."},{"name":"Emory Vaccine Center, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Centers for Disease Control and Prevention. HIV Surveillance Report 2020. US Department of Health and Human Services: Atlanta GA 2022."},{"key":"e_1_3_5_3_2","unstructured":"Centers for Disease Control and Prevention. CDC Fact Sheet: HIV Incidence: Estimated Annual Infections in the U.S. 2014\u20132018. US Department of Health and Human Services: Atlanta GA 2020."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.7954"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(18)30132-2"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600693"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30418-0"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5148"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21167"},{"key":"e_1_3_5_10_2","unstructured":"Centers for Disease Control and Prevention. Understanding the HIV Care Continuum. US Department of Health and Human Services: Atlanta GA 2019."},{"key":"e_1_3_5_11_2","unstructured":"Office of National AIDS Policy. National HIV\/AIDS Strategy for The United States: Updated to 2020. The White House: Washington DC 2015."},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0990-0"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2010.0065"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1809-3"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001242"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325957417711254"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000606"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1826-2"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239190"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1687-8"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu357"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-11-201006010-00003"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000760"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000707"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2017.0313"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz537"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002843"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-015-0285-5"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1886-3"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2022.0065"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2022.0102"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2022.0141"},{"key":"e_1_3_5_33_2","unstructured":"US President's Emergency Plan for AIDS Relief (PEPFAR). PEPFAR Five-Year Strategy: Fulfilling America's Promise to End the HIV\/AIDS Pandemic by 2030. US Department of State: Washington DC 2022."},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1460-4"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz294"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2019.0310"},{"key":"e_1_3_5_37_2","unstructured":"Anonymous. POP-UP | HIV ID and Global Medicine; n.d. Available from: https:\/\/hividgm.ucsf.edu\/pop-up [Last accessed: April11 2021]."},{"key":"e_1_3_5_38_2","unstructured":"Centers for Disease Control and Prevention. HIV in the Southern United States. US Department of Health and Human Services: Atlanta GA 2019."},{"key":"e_1_3_5_39_2","unstructured":"Centers for Disease Control and Prevention. Ending the HIV Epidemic: A Plan for America. US Department of Health and Human Services: Atlanta GA 2020."},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2021.0067"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000158"},{"key":"e_1_3_5_42_2","unstructured":"Commissioner O of the. FDA Approves First Extended-Release Injectable Drug Regimen for Adults Living with HIV. FDA; 2021. Available from: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-extended-release-injectable-drug-regimen-adults-living-hiv [Last accessed: 4\/13\/2021]."},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1258451"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000403"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1080\/08964289.2018.1534076"}],"container-title":["AIDS Patient Care and STDs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/apc.2023.0061","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/apc.2023.0061","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/apc.2023.0061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:08:40Z","timestamp":1777399720000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/apc.2023.0061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":44,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1089\/apc.2023.0061"],"URL":"https:\/\/doi.org\/10.1089\/apc.2023.0061","relation":{},"ISSN":["1087-2914","1557-7449"],"issn-type":[{"value":"1087-2914","type":"print"},{"value":"1557-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}