Prioritize NIC List for Follow-Up and Outreach
Some health departments might not be able to follow up on every HIV-diagnosed “not in care” (NIC) person on their list. After refining the initial NIC list through investigation, Data to Care programs utilizing a Health Department Model might need to prioritize with whom they follow up if it is not possible to contact everyone. For Data to Care programs utilizing a Healthcare Provider Model, the health department might find prioritization unnecessary or they might need the healthcare provider to prioritize the information for them. We strongly encourage follow-up with all HIV-diagnosed NIC persons, but programs might not be able to follow up with everyone due to limited resources.
When follow-up with all NIC persons is not possible, Data to Care programs might need selection criteria for prioritizing and selecting individuals for follow-up. For example, jurisdictions might prioritize people with more recent diagnoses ahead of older diagnoses, with the intention of increasing the likelihood of locating the individual. Jurisdictions also might choose to prioritize cases that might be recent infections (e.g., acute infection) ahead of those who have more long-standing infection, with the intention of disease interruption among those more likely to transmit infection. In making these decisions, health departments should consider carefully the impact to both the individuals who will not receive follow-up as well as the impact to ongoing HIV transmission in the population.
Examples of other data from the NIC list that Data to Care programs might use to prioritize individuals for follow-up include:
- Time from last care visit
- Time since any new information reported to HIV surveillance program
- Most recent unsuppressed viral load
- Geographic area of current residence
- Transmission category
- Race/ethnicity
- Current age
If a health department elects to prioritize cases for follow-up based on geographic areas with high numbers of diagnosed NIC individuals, they might find geospatial mapping a useful tool in identifying these areas. HICSB has guidance for conducting geospatial mapping of HIV surveillance data in its Technical Guidance for HIV Surveillance Programs.