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NC-LINK to combat HIV collaboratively

Universities across the state have joined forces to offer new resources in the battle against HIV.

The Duke Center for Health Policy & Inequalities Research is partnering with three other universities and the communicable diseases branch of the North Carolina Department of Health and Human Services in a multi-million dollar initiative to combat HIV. The initiative, called NC-LINK, is designed to increase the number of people getting tested for HIV and improve access to treatment for those who already know if they are positive for the disease.

“We are hoping this intervention will make a meaningful change in the state-level rates of testing and people engaged in appropriate HIV care,” said Lynne Messer, assistant professor of global health at CHPIR and Duke’s principle investigator for the initiative. “The state-wide data structure that we will be building over the next four years will allow those who care for HIV-positive clients to know if their people are appropriately engaged in care or have somehow been lost.”

The project is funded by a grant of up to $1 million per year for four years from the Health Resources and Services Administration Special Projects of National Significance. East Carolina University, the University of North Carolina at Chapel Hill and Wake Forest University are the other partner universities.

The initiative will target four gaps in HIV and AIDS care—those who are either unaware, out of care, lost to care or receive sporadic care. To combat these gaps, NC-LINK will provide increased testing opportunities to people around the state. In North Carolina, an estimated 21 percent of HIV positive people are unaware of their HIV status, Messer said.

“We are just beginning work and are really hopeful for what this project will be able to accomplish over the next few years,” she said. “We are hoping to make some meaningful change in the proportions of people who are HIV-infected and are unaware and out of care.”

Besides reducing the number of people who do not know that they are HIV positive, the program aims to reduce the number of people who do not receive care for more than three months after diagnosis, to improve quality of services through shared data systems and to reduce the number of people who do not receive at least the basic level of services, State AIDS/STD Director Jacquelyn Clymore wrote in an email Tuesday. Clymore is also a principal investigator for the initiative.

“We want to make sure that all HIV-positive people benefit from medical care,” said Dr. Byrd Quinlivan, associate professor of medicine and director of the infectious diseases clinic at the UNC and leader of the effort at UNC-Chapel Hill. “The other goals are to make the time between testing and medical care shorter and to keep people coming to their doctor at least two times each year after they are stable on medications.”

Quinlivan noted that only about half of people infected are symptomatic when the acquire the infection. Without symptoms, many people do not think to go to the doctor or clinc to be tested.

The program is not the first initiative in the state to combat HIV and raise awareness. Previous efforts include the Get Real Get Tested campaign and public service announcements, Clymore said.

“NC-LINK will work closely with some of our community partners to increase testing and to locate difficult-to-reach populations who are at the greatest risk of contracting HIV, through emergency room testing [and] internet [and] social media outreach,” she said.

Besides CHPIR, the state Department of Health and Human Services, the Center of Infectious Diseases at the University of North Carolina at Chapel Hill, Wake Forest Baptist Health Center and East Carolina University are collaborating on the project and share a common goal of controlling the disease.

“Thus far, HIV has evaded our efforts to control its spread. As we reduce cases in one area another area or population has increased rates,” Quinlivan said. “We will not make progress unless we work together.”

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