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APHA Scientific Session and Event Listing

Frank M. Lombard, LCSW, Betsy Barton, MPH, and Carlotta McNeill, BA. Center for Health Policy - Health Inequalities Program, Duke University, 302 Towerview Road, Rubenstein Hall, Durham, NC 27708, 919-613-9365, flombard@hpolicy.duke.edu

Issues: The impact of HIV/HCV co-infection on mortality and morbidity requires strategies for integration of care among specialty providers. This poses challenges when the focus of the problem is defined differently among providers. The paradigm of HCV as a viral infection can lead to foundational differences in perspective from those developed from the concept of HCV as a disease of the liver. These differences in understanding of a disease state, especially in sub-specialty populations such as the HIV/HCV co-infection, can lead to significant treatment approaches, misunderstanding of provider roles, and ultimately decreased access to needed specialty care.

Description The Piedmont HIV Community Access System (PHICAS) is funded through the Health Resources Services Administration's (HRSA) Bureau of Primary Health Care's (BPHC) Healthy Communities Access Program (HCAP). PHICAS' goal is to develop a collaborative network of providers in a six county region to link and coordinate services for those co-infected with HCV/HIV.

Lessons Learned Variability in care protocols among specialty care providers has impact on health outcomes. Developing commonly understood protocols is complicated with differences in provider perspectives of the disease state to be managed or treated. This is complicated when the disease states have components of behavioral health that need to be managed.

Recommendations Develop: Client-focused approaches to disease and treatment approaches; Strategies for fostering discussion of treatment paradigms in formal and informal arenas; Approaches to cross training that focus both on knowledge/ skills development and relationship building using language comfortable for types of providers.

Learning Objectives:

• Identify barriers to effective collaborations between different specialty providers
• Describe effective strategies od care integration in sub specialty patient populations
• Apply lessons learned to the development of effective training protocols.

Presenting author's disclosure statement:

Not Answered