Abstract

A significant proportion of PWH in the U.S. remain out of care. Yet existing tools are ill-equipped to proactively identify and prioritize those at risk for disengagement. The cumulative and intersecting barriers to care often interact with individual-level characteristics shaping whether a person remains engaged in care. This project proposes to develop a multi-domain risk assessment instrument grounded in the socioecological and COM-B frameworks, to identify those at high risk of disengagement, before they fall out of care, enabling equitable resource allocation and interventions. We will develop the survey in collaboration with community members, use psychometric methods to confirm the tool’s reliability, and construct validity, derive a domain-based scoring algorithm to quantify risk for disengagement, and evaluate the tool’s predictive validity and feasibility to transform retrospective outreach for people who are out of care into a proactive tool to improve retention in care and HIV viral suppression rates.