Improving Referrals for HIV Care Through Organizational Network Analysis

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Healthcare Management

Background:

• The link between HIV testing and antiretroviral therapy (ART) is crucial for global HIV/AIDS control strategies like UNAIDS' "90-90-90" goals.
• Effective patient referral between service providers is essential to ensure individuals diagnosed with HIV/AIDS initiate and adhere to ART.

Purpose of the Study:

• To identify organizations involved in HIV/AIDS care in Homa Bay, Kenya, a region with high HIV prevalence.
• To investigate the existing collaboration and referral networks among these organizations.
• To assess the effectiveness of these networks in providing comprehensive HIV/AIDS care, particularly the linkage from testing to treatment.

Main Methods:

• A comprehensive survey of 56 organizations providing HIV/AIDS care in Homa Bay County.
• Interviews with representatives from each organization to detail services offered and inter-organizational connections.
• Specific focus on referral pathways from HIV testing sites to ART-providing facilities.

Main Results:

• Referral connections among the 56 organizations were infrequent, averaging less than two per organization in the past 30 days.
• Thirteen organizations reported making no referrals, and five HIV testing facilities did not refer clients to ART providers.
• Two distinct clusters of interconnected organizations were identified: one in Homa Bay Township and another in Rangwe subcounty.

Conclusions:

• Homa Bay has a significant opportunity to enhance HIV/AIDS care by improving the utilization of existing services.
• Better coordination and information sharing about available services among organizations can strengthen the referral process.
• Implementing targeted strategies within identified organizational clusters can improve the continuum of care from HIV testing to ART initiation and viral suppression.