{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:58:17Z","timestamp":1767085097766,"version":"3.40.5"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We explore trends in linkage to HIV care following diagnosis and investigate the impact of diagnosis setting on linkage in the era of expanded testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All adults (aged\u00a0\u2265\u00a015\u00a0years) diagnosed with HIV between 2005 and 2014 in England, Wales and Northern Ireland (EW&amp;NI) were followed up until the end of 2017. People who died within 1\u00a0month of diagnosis were excluded (<jats:italic>n<\/jats:italic>\u00a0=\u00a01009). Trends in linkage to outpatient care (time to first CD4 count) were examined by sub\u2010population and diagnosis setting. Logistic regression identified predictors of delayed linkage of &gt;\u00a01\u00a0month, &gt;\u00a03\u00a0months and &gt;\u00a01\u00a0year post\u2010diagnosis (2012\u20132014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 97% (60\u00a0250\/62\u00a0079) of people linked to care; linkage \u2264\u00a01\u00a0month was 75% (44\u00a0291\/59\u00a0312), \u2264\u00a03\u00a0months was 88% (52\u00a0460) and \u2264\u00a01\u00a0year was 95% (56\u00a0319). Median time to link declined from 15\u00a0days [interquartile range (IQR): 4\u201343] in 2005 to 6 (IQR: 0\u201320) days in 2014 (similar across sub\u2010populations\/diagnosis settings). In multivariable analysis, delayed linkage to care was associated with acquiring HIV through injecting drug use, heterosexual contact or other routes compared with sex between men (&gt;\u00a01\u00a0month\/3\u00a0months\/1\u00a0year), being diagnosed in earlier years (&gt;\u00a01\u00a0month\/3\u00a0months\/1\u00a0year) and having a first CD4 \u2265 200 cells\/\u03bcL (&gt;\u00a03\u00a0months\/1\u00a0year). Diagnosis outside of sexual health clinics, antenatal services and infectious disease units predicted delays of &gt;\u00a01\u00a0month. By 3\u00a0months, only diagnosis in \u2018other\u2019 settings (prisons, drug services, community and other medical settings) was significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Linkage to care following HIV diagnosis is relatively timely in EW&amp;NI. However, non\u2010traditional testing venues should have well\u2010defined referral pathways established to facilitate access to care and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13078","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T03:48:07Z","timestamp":1612583287000},"page":"491-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends and predictors of linkage to HIV outpatient care following diagnosis in the era of expanded testing in England, Wales and Northern Ireland: Results of a national cohort study"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2220-623X","authenticated-orcid":false,"given":"S","family":"Croxford","sequence":"first","affiliation":[{"name":"National Infection Service Public Health England London UK"},{"name":"Institute for Global Health University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Burns","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London London UK"},{"name":"Royal Free London NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Copas","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Yin","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-8109","authenticated-orcid":false,"given":"V","family":"Delpech","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_7_2_1","DOI":"10.2807\/1560-7917.ES.2017.22.25.30553"},{"doi-asserted-by":"publisher","key":"e_1_2_7_3_1","DOI":"10.1111\/hiv.12617"},{"volume-title":"Guidelines for HIV testing 2008","year":"2008","author":"British HIV Association, British Association for STI and HIV, British Infection Society","key":"e_1_2_7_4_1"},{"volume-title":"HIV testing: increasing uptake among people who may have undiagnosed HIV","year":"2016","author":"National Institute of Health and Care Excellence","key":"e_1_2_7_5_1"},{"volume-title":"HIV testing: encouraging uptake","year":"2017","author":"National Institute of Health and Care Excellence","key":"e_1_2_7_6_1"},{"volume-title":"International AIDS Society Conference","author":"Cieply 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