AIDS and Behavior

, Volume 22, Issue 8, pp 2615–2626 | Cite as

Exploring the Correlates of Linkage to HIV Medical Care Among Persons Living with HIV Infection (PLWH) in the Deep South: Results and Lessons Learned from the Louisiana Positive Charge Initiative

  • Russell A. Brewer
  • Sarah Chrestman
  • Snigdha Mukherjee
  • Karen E. Mason
  • Typhanye V. Dyer
  • Peter Gamache
  • Mary Moore
  • DeAnn Gruber
Original Paper


We explored the correlates of linkage to HIV medical care and barriers to HIV care among PLWH in Louisiana. Of the 998 participants enrolled, 85.8% were successfully linked to HIV care within 3 months. The majority of participants were male (66.2%), African American (81.6%), and had limited education (74.4%). Approximately 22% of participants were Black gay and bisexual men. The most common reported barrier to care was lack of transportation (27.1%). Multivariable analysis revealed that compared with Black gay and bisexual men, White gay and bisexual men were significantly more likely to be linked to HIV care (adjusted prevalence ratio, aPR 1.08, 95% CI 1.02–1.13). Additionally, participants reporting moderate to high levels of stigma at intake (p < 0.05) were significantly more likely to be linked to HIV care compared with those reporting low or no stigma at enrollment. Study findings highlight the continued importance of client-centered interventions and multi-sector collaborations to link PLWH to HIV medical care.


HIV South HIV care Barriers Stigma MSM 



We would like to thank all study participants; Susan Bergson, MPH; the interventionists; the intervention sites; and our collaborative partners in Louisiana. This project was supported by a grant from AIDS United.

Author Contributions

RAB generated the initial concept, reviewed the analysis results, drafted specific sections of the article, updated subsequent drafts, and completed the final version for publication. SC, SM, PG, and DG also helped design the initial concept, reviewed the analysis results, and drafted specific sections of the article. KEM ran the analyses, reviewed the analysis results, and drafted the results section. TVD and MM re-coded the data, re-ran the analyses, reviewed the analysis results, and contributed to revising all sections of the manuscript. In addition, RAB and DG served as co-investigators of the study.


This project was funded by AIDS United and Bristol-Myers Squibb. R.A. Brewer’s time was also supported by a Grant from NIMH (R25MH067127) for the Visiting Professor Program at the University of California, San Francisco.

Compliance with Ethical Standards

Ethical Approval

Ethical approval for this analysis was obtained from The Louisiana Department of Health’s Institutional Review Board (IRB) in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional Review Board approval was obtained for the study.

Conflict of interest

The authors have no conflicts of interest.

Informed Consent

Informed consent was obtained from all interviewed participants in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Louisiana Public Health InstituteNew OrleansUSA
  3. 3.Foundation for Advancement of International Medical Education and ResearchPhiladelphiaUSA
  4. 4.Department of Epidemiology and BiostatisticsThe University of MarylandCollege ParkUSA
  5. 5.Turnaround Achievement Network, LLCTampaUSA
  6. 6.Dillard UniversityNew OrleansUSA
  7. 7.Louisiana Office of Public Health, STD/HIV ProgramNew OrleansUSA

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