Defining linkage to care following human immunodeficiency virus (HIV) diagnosis for public health monitoring in Europe

OptTEST by HIV in Europe

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Prompt linkage to human immunodeficiency virus (HIV) care after diagnosis is crucial to ensure optimal patient outcomes. However, few countries monitor this important public health marker and different definitions have been applied, making country and study comparisons difficult. This article presents an expert-agreed, standard definition of linkage to care for a pragmatic approach to public health monitoring, appropriate to the European context. Here, linkage to care is defined as patient entry into specialist HIV care after diagnosis, measured as the time between the HIV diagnosis date and one of the following markers: either the first clinic attendance date, first CD4+ cell count or viral load date, or HIV treatment start date, depending on data availability; Linkage is considered prompt if within 3 months of diagnosis. Application of this definition by researchers and public health professionals when reporting surveillance or research data relating to linkage to care after HIV diagnosis will enable reliable comparisons across countries, better assessment of the success of health services programmes aimed at improving peoples access to HIV treatment and care and the identification of barriers limiting access to HIV care across Europe.

Original languageEnglish
Article number1700858
Issue number48
Publication statusPublished - 29 Nov 2018

Bibliographical note

Funding Information:
This paper was co-funded by the European Commission and Public Health England as part of OptTEST by HIV in Europe (Grant #: 20131102). We would like to thank the ECDC, the European HIV Surveillance Network and all other attendees of the continuum of care meeting for their contributions toward developing the definition. We would also like to acknowledge our OptTEST and Euro HIV EDAT project partners for their contributions and input in putting together this manuscript, as well as the OptTEST project steering committee: Jorrit Kabel (AIDS Fonds), Anne-Isabelle Von Lingen (EATG), Ann Sullivan (St Stephen’s AIDS Trust), Yazdan Yazdanpanah (INSERM), Julian Hows (GNP+), Julia Del Amo (ISC III), Kristi Rüütel (NIHD – Estonia) and Jens Lundgren (CHIP). Finally, we would like to thank the ECDC, the WHO Regional Office for Europe and the ECDC/WHO national HIV surveillance focal points for their involvement in the OptTEST survey.

Publisher Copyright:
© 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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