Cloete, ChristieRegan, SusanGiddy, JanetGovender, TessaErlwanger, AlisonGaynes, Melanie R.Freedberg, KennethKatz, JeffreyWalensky, RochelleLosina, ElenaBassett, Ingrid2015-04-012014Cloete, C., S. Regan, J. Giddy, T. Govender, A. Erlwanger, M. R. Gaynes, K. A. Freedberg, et al. 2014. “The Linkage Outcomes of a Large-scale, Rapid Transfer of HIV-infected Patients From Hospital-based to Community-based Clinics in South Africa.” Open Forum Infectious Diseases 1 (2): ofu058. doi:10.1093/ofid/ofu058. http://dx.doi.org/10.1093/ofid/ofu058.2328-8957http://nrs.harvard.edu/urn-3:HUL.InstRepos:14351069Background: President's Emergency Plan for AIDS Relief (PEPFAR) funding changes have resulted in human immunodeficiency virus (HIV) clinic closures. We evaluated linkage to care following a large-scale patient transfer from a PEPFAR-funded, hospital-based HIV clinic to government-funded, community-based clinics in Durban. Methods: All adults were transferred between March and June 2012. Subjects were surveyed 5–10 months post-transfer to assess self-reported linkage to the target clinic. We validated self-reports by auditing records at 8 clinics. Overall success of transfer was estimated using linkage to care data for both reached and unreached subjects, adjusted for validation results. Results: Of the 3913 transferred patients, 756 (19%) were assigned to validation clinics; 659 (87%) of those patients were reached. Among those reached, 468 (71%) had a validated clinic record visit. Of the 46 who self-reported attending a different validation clinic than originally assigned, 39 (85%) had a validated visit. Of the 97 patients not reached, 59 (61%) had a validated visit at their assigned clinic. Based on the validation rates for reached and unreached patients, the estimated success of transfer for the cohort overall was 82%. Conclusions: Most patients reported successful transfer to a community-based clinic, though a quarter attended a different clinic than assigned. Validation of attendance highlights that nearly 20% of patients may not have linked to care and may have experienced a treatment interruption. Optimizing transfers of HIV care to community sites requires collaboration with receiving clinics to ensure successful linkage to care.en-USPEPFARtransfer of HIV careSouth Africalinkage to carecommunity-based clinicsJournal Article2015-04-0110.1093/ofid/ofu058