Linkage, engagement, and retention in HIV care among vulnerable populations: "I"m sick and tired of being sick and tired".

There are disparities in engagement and retention in HIV care and outcomes of care across segments of society. For example, HIV mortality rates remain markedly elevated among black women and men compared with their white counterparts. These differences reflect broader disparities across social, economic, and cultural lines. Improvement in engagement and retention in HIV care requires interventions that account for forces present in the socioecologic framework of health behaviors. Improvement in linkage to care at HIV testing is crucial to overall engagement and retention in care. Strategies for linkage to care at testing can help overcome many of the forces that result in failure to engage and remain in care by starting the patient on a solid path to clinical care. This article summarizes a presentation by Victoria A. Cargill, MD, MSCE, at the IAS-USA continuing education program held in New York, New York, in May 2013.