Is HIV patient navigation associated with HIV care continuum outcomes?

Background

HIV patient navigation is a patient-centered healthcare intervention in which navigators help persons with HIV find their way through complicated healthcare systems and remove barriers to engagement in care. As more studies of HIV patient navigation are completed, it is important to evaluate all findings to know if the intervention is effective.

Questions addressed in the review

• Is HIV patient navigation positively associated with HIV care outcomes (linkage to care, retention in care, uptake of HIV medication, medication adherence, and viral suppression)?
• How strong is the evidence?
• What are the unanswered questions and research gaps in the studies of HIV patient navigation identified for this review?

Search date

The review was finalized in May 2018 and covers publication years 1996-April 2018.

Study characteristics

We included 20 U.S.-based studies in the review. The people included in the studies were persons with HIV who had challenges staying in HIV care. The studies took place mostly in clinics or community-based organizations.

Key results

Seventeen of the 20 studies in the review reported positive findings. HIV patient navigation was positively associated with HIV care outcomes, particularly linkage to care, retention in care, and viral suppression. Positive findings were more likely to be found in studies with weaker study quality.

HIV patient navigation is potentially effective for improving engagement in care among persons with HIV. More studies with stronger designs are needed to form a solid evidence base.

Few studies reported characteristics of patient navigators. It is unknown whether HIV patient navigation works differently across different HIV patient populations. It is also unknown what characteristics of navigation programs are associated with better outcomes.

Quality of the evidence

The overall quality of the evidence was weak as few studies with positive findings were randomized controlled trials and many were rated as weak study quality.

Study funding source

This study was funded by the Centers for Disease Control and Prevention.

Related Resources

• HIV Navigation Services
• STEPS to Care: Patient Navigation