{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:10:58Z","timestamp":1788667858766,"version":"build-2803163510"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100012765","name":"Baltimore City Health Department","doi-asserted-by":"publisher","award":["PS 18-1802"],"award-info":[{"award-number":["PS 18-1802"]}],"id":[{"id":"10.13039\/100012765","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012304","name":"School of Medicine, Johns Hopkins University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012304","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"abstract":"\n Background:<\/jats:bold>\n Emergency department (ED)-based HIV linkage-to-care programs effectively connect newly diagnosed people living with HIV (PLWH) to care and can also facilitate re-engagement among patients disengaged from HIV care. The linkage-to-care needs of these populations may differ substantially. We sought to identify factors associated with engagement outcomes following ED-based re-linkage to inform service delivery.\n Methods:<\/jats:bold>\n This cross-sectional analysis used programmatic data from an ED-based HIV linkage-to-care program that served PLWH identified by automated electronic health record alerts to program staff upon ED presentation from January 2023 to July 2024. Patients were classified as not engaged in HIV care if, within the preceding three months, they had missed at least one HIV care appointment without rescheduling and had not refilled their antiretroviral therapy (ART). These individuals were approached at the bedside and offered re-linkage-to-care services. Among patients who received re-linkage-to-care services, the primary outcome was attendance at the scheduled HIV care appointment. ART refill within three months of the scheduled appointment was assessed descriptively. Associations between sociodemographic and clinical characteristics and appointment nonattendance were evaluated using univariate and multivariable logistic regression models.\n Results:<\/jats:bold>\n Among 892 PLWH presenting to the ED, 113 (13%) were classified as not engaged in HIV care, of whom 66 (58%) received re-linkage-to-care services. All 66 patients who received re-linkage-to-care services had an HIV care appointment scheduled, and 40 (61%) attended their scheduled appointment. In adjusted analyses, patients with a history of substance use disorder had greater odds of appointment non-attendance (aOR=4.50, 95% CI 1.57-14.88;\n p<\/jats:italic>\n = 0.03). All patients who attended subsequently refilled ART.\n Conclusions:<\/jats:bold>\n A history of substance use disorder was associated with greater odds of HIV care appointment nonattendance following ED-based re-linkage-to-care services, highlighting the need for tailored substance use disorder informed strategies that address social, behavioral, and structural barriers to sustained HIV care engagement.\n <\/jats:p>","DOI":"10.1177\/09564624261483246","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:28:11Z","timestamp":1788492491000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges to sustained HIV care engagement after ED Re-linkage: The influence of substance use disorders"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5488-377X","authenticated-orcid":false,"given":"Haley","family":"Haines","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Rothman","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhakti","family":"Hansoti","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyah","family":"Johnson","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mun Heol","family":"Cho","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dante","family":"Brown","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5230-4223","authenticated-orcid":false,"given":"David","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve","family":"Barrow","sequence":"additional","affiliation":[{"name":"Baltimore City Health Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adena","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"Baltimore City Health Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Jones","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaye","family":"Park","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"Saheed","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1616-8014","authenticated-orcid":false,"given":"Yu-Hsiang","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaby","family":"Dashler","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_3_9_2_2","first-page":"1","article-title":"Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings","volume":"55","author":"Branson BM","year":"2006","unstructured":"Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep 2006; 55: 1\u201317. quiz CE1-4.","journal-title":"MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep"},{"key":"e_1_3_9_3_2","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/adult-and-adolescent-arv (2025). accessed 28 February 2026."},{"key":"e_1_3_9_4_2","first-page":"157","article-title":"Creating and implementing Wisconsin\u2019s first emergency department-based universal opt-out HIV testing program","volume":"124","author":"Petroll A","year":"2025","unstructured":"Petroll A, Woodbury J, Chin M, et al. Creating and implementing Wisconsin\u2019s first emergency department-based universal opt-out HIV testing program. WMJ Off Publ State Med Soc Wis 2025; 124: 157\u2013161.","journal-title":"WMJ Off Publ State Med Soc Wis"},{"key":"e_1_3_9_5_2","unstructured":"Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data\u2014United States and 6 territories and freely associated states. https:\/\/www.cdc.gov\/hiv-data\/nhss\/national-hiv-prevention-and-care-outcomes.html (2025). accessed 11 March 2026."},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001195"},{"key":"e_1_3_9_7_2","unstructured":"Posit team. RStudio: integrated development environment for R. (2025). https:\/\/www.posit.co\/"},{"key":"e_1_3_9_8_2","first-page":"117822182097698","article-title":"Targeting the barriers in the substance use disorder continuum of care with peer recovery support","volume":"15","author":"Stanojlovi\u0107 M","year":"2021","unstructured":"Stanojlovi\u0107 M, Davidson L. Targeting the barriers in the substance use disorder continuum of care with peer recovery support. Subst Abuse Res Treat 2021; 15: 1178221820976988. https:\/\/doi.org\/10.1177\/1178221820976988","journal-title":"Subst Abuse Res Treat"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2024.0228"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13577"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2024.06.003"}],"container-title":["International Journal of STD & AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261483246","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261483246","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261483246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T03:39:20Z","timestamp":1788665960000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261483246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":10,"alternative-id":["10.1177\/09564624261483246"],"URL":"https:\/\/doi.org\/10.1177\/09564624261483246","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"09564624261483246"}}