# P-276. Temporal Trends in Racial Disparities of HIV Linkage-to-Care within Emergency Department-Based Testing Programs at a Community Healthcare System, 2018–2024

## TL;DR

This study examines HIV care linkage rates in an emergency department testing program in South Florida from 2018 to 2024, finding no significant racial disparities but suboptimal overall outcomes.

## Contribution

The study provides a detailed analysis of racial disparities in HIV linkage-to-care within a community ED-based testing program over six years.

## Key findings

- The average linkage-to-care rate was 82.8%, with no statistically significant differences across racial groups.
- Temporal trends showed stable linkage-to-care rates with no significant changes for any racial group from 2018 to 2024.
- The study highlights the need for innovative strategies to improve linkage-to-care outcomes in ED-based HIV testing programs.

## Abstract

Emergency department (ED)-based HIV testing programs have been widely implemented across the United States. Linkage-to-care rates among newly diagnosed individuals with HIV vary widely and many remain suboptimal. We aim to evaluate the overall linkage-to-care rate and explore temporal trends in racial disparities of linkage-to-care from 2018 to 2024 within an ED-based HIV testing program at a community healthcare system in South Florida.Figure 1.Trends in linkage-to-care rates by racial group within the Memorial Healthcare System ED-based HIV testing program from 2018 to 2024.(A) Linkage-to-care rates (%) across racial groups by year within the Memorial Healthcare System ED-based HIV testing program from 2018 to 2024. (B) Temporal trends in linkage-to-care rates (%) across racial groups by year within the Memorial Healthcare System ED-based HIV testing program from 2018 to 2024, assayed using Joinpoint regression analysis.

Trends in linkage-to-care rates by racial group within the Memorial Healthcare System ED-based HIV testing program from 2018 to 2024.

(A) Linkage-to-care rates (%) across racial groups by year within the Memorial Healthcare System ED-based HIV testing program from 2018 to 2024. (B) Temporal trends in linkage-to-care rates (%) across racial groups by year within the Memorial Healthcare System ED-based HIV testing program from 2018 to 2024, assayed using Joinpoint regression analysis.

This retrospective analysis utilized data from the Memorial Healthcare System’s ED-based HIV screening program (2018–2024) to quantify linkage-to-care rates and assess racial disparities in care linkage. Annual percentage change (APC) was measured using Joinpoint regression models to describe the temporal trends in HIV linkage-to-care rates from July 2018, when the screening program was initiated, to December 2024, based on the most recent data available at the time of analysis.

From 2018 to 2024, the average HIV linkage-to-care rate of the ED-based HIV testing program was 82.8%. The average linkage-to-care rates were 84.1% among Black/African American individuals, 75.4% among non-Hispanic White individuals, and 77.9% among Hispanic individuals, with no statistically significant differences between races (p = 0.241) (Figure 1A). When using APC as an outcome, the temporal trend of the overall HIV linkage-to-care rate was stable from 2018 to 2024, with an APC of -0.32% (95% confidence interval [CI], -7.91 to 7.97; p = 0.935). There were no statistically significant changes in linkage-to-care rates across races from 2018 to 2024, with an APC of -3.37% (95% CI, -9.95 to 3.53; p = 0.345) for Black/African American individuals, 11.31% (95% CI, -5.05 to 30.5; p = 0.209) for non-Hispanic White individuals, and -0.32% (95% CI, -7.91 to 7.97; p = 0.935) for Hispanic individuals, respectively (Figure 1B).

Our findings suggest that linkage-to-care rates within an ED-based HIV testing program in South Florida have remained suboptimal over the years, and no significant racial disparities in care linkage were revealed. Innovative strategies to improve linkage-to-care outcomes for all patients should be developed and integrated into ED-based HIV testing initiatives to enhance program effectiveness and improve patient outcomes.

All Authors: No reported disclosures