Quality improvement approach for increasing linkage to HIV care and treatment among newly-diagnosed HIV-infected persons in Kenyan urban informal settlements during 2011–2015

Background: Pre-enrollment loss to follow-up and delayed linkage to HIV care and treatment (CT Phase 2 – use of linkage registers and timely tracking and tracing individuals who missed appointments; Phase 3 – use of patient HIV literacy materials. Routine patient data collected during the CQI interventions implemented between October 2011 and September 2015 were analyzed.Results: Implementation of the three CQI phases significantly increased linkage to HIV CT female sex [OR 0.64, (95% CI: 0.59-0.70)] and unemployement [OR 0.84, (95% CI: 0.77-0.92)]. First time tester [OR 1.9, (95% CI: 1.8-2.1)] and divorcees [OR 2.0, (95% CI: 1.7-2.3)], (p<0.001) had increased likelihood of linkage to HIV C&T.Conclusion: Successful linkage to HIV C&T services for newly-diagnosed HIV-infected individuals is achievable through adoption of feasible and low-cost multi-pronged CQI interventions.