Study examines continuum of HIV care in Toronto

By Ana Gajic

A recent study led by St. Michael’s Hospital and Casey House set out to evaluate HIV-specific care for vulnerable and medically complex people with HIV who were discharged from Casey House, an HIV specialty hospital.

The researchers found that a large number of people experience interruptions in their HIV care, potentially placing them at risk of poor outcomes related to HIV care.

Published online in Open Forum Infectious Diseases and led by Dr. Tony Antoniou, a scientist at the Li Ka Shing Knowledge Institute and Soo Chan Carusone, a researcher at Casey House, the research team used ICES data for this work. The team examined the proportion of people filling a prescription for HIV medication within seven days of discharge from Casey House, and the number of patients with a follow-up with an HIV provider within 30 days of discharge.

We asked the team about their work and findings.

Q. Why did you study this topic?

We know from experience that Casey House clients are disproportionately affected by factors that affect access to care, such as mental health illness and poverty. In these cases, finding out that linkage to care is suboptimal means that we need to take more steps to optimize the care and health of these patients.

Q. What were the key findings?

Despite comprehensive discharge planning, our study showed that only 22 of 206 of people – about 10 per cent – discharged from Casey House filled a prescription for HIV medications within seven days of discharge. Although approximately 75 per cent of patients reconnected with a provider within 30 days of discharge, this may be suboptimal when considering the medical complexity of this population.

Q. Why is this research important?

Our principal concern is that a large proportion of these clients are experiencing interruptions in HIV treatment, which could place them at risk of poor outcomes related to HIV care.

Q. What’s next for this research?

Our next steps will be to understand which additional supports are needed to facilitate linkage to care and timely HIV treatment for vulnerable and medically complex adults living with HIV as they transition back to the community.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.