Reduced Viral Load Burden among Ryan White Medical Case Management Clients in the Southeast

Background: Medical case management is intended to engage clients in obtaining routine HIV medical care and result in greater adherence to antiretroviral drug regimens. Further, medication adherence has been proven to be directly related to lower viral load levels in HIV patients. This analysis compares variations in viral load levels and the number of medical visits among Ryan White clients that are and are not medical case management clients.

Methods: To examine the differences between the two groups, calendar year 2009 laboratory and service data reported by Ryan White funded agencies were utilized. The Independent Samples t-Test was employed to determine the significance of the difference in mean viral load levels and mean number of medical visits between the groups.

Results: The mean viral load level (18,525 copies/ml) was lower and the mean number of medical visits (6.4 visits) was higher for the group that received medical case management in 2009 compared to the group that did not (24,836 copies/ml, 5.7 visits). The difference in mean viral load level between the groups was statistically significant (p<.05) as well as the difference in the mean number of medical visits between the groups (p<.05).

Conclusions: The receipt of medical case management is successful in reducing viral load burden among HIV clients. Medical case management clients are more routinely obtaining primary medical care resulting in improved health status.