Pilot Award Recipient: Rupali Doshi, MD, MS

Understanding how traumatic life events and mental illness affect engagement in HIV care among people living with HIV in Washington, DC

Dr. Doshi
January 08, 2019
In the District of Columbia (DC), roughly 13,000 people, or 1.9% of the population, is living with HIV, one of the highest concentrations in the United States. However, only 63% were virally suppressed in 2017. By taking antiretroviral therapy (ART) to achieve viral suppression, people living with HIV (PLWH) can live longer, healthier lives, and reduce the risk of transmitting HIV to others. To achieve the best possible health outcomes, PLWH must regularly engage with the HIV care system. For some people, especially those with a history of traumatic life events or mental illness, this may be especially difficult. There is an urgent need to identify successful interventions to improve re-engagement of people living with HIV (PLWH) who are out-of-care or not virally suppressed in DC. One way to find a successful intervention is to get a better understanding of how traumatic life events and mental illness might affect engagement in HIV care.
DC Department of Health is leading the Data-to-Care program in which surveillance and provider data identifies out-of-care (OOC) or viremic (viral load over 200 copies/ml) PLWH in DC. Health department staff and community-based providers use locating information to find people who may need extra assistance getting back into care and achieving their optimal health.
This study builds upon the Data-to-Care program and proposes to:
(1) Survey 100 PLWH who are out-of-care or viremic to find out how many have a history of traumatic life events and/or mental illness, and if they have those, find out if they have been treated; and
(2) Conduct one-on-one, in-person interviews among 20 PLWH who have a history of inconsistent or no HIV care in the past 5 years and history of traumatic life events and/or mental illness to understand their experiences accessing care and find out which types of interventions would be acceptable for a future study to help keep people in continuous HIV care.