267066 State of HIV in primary care survey: Impacts of a rapidly evolving landscape on access to quality HIV care

Monday, October 29, 2012 : 12:45 PM - 1:00 PM

Michael D. Shankle, MPH , HealthHIV, Washington, DC
Nicholas Welch, MPH , Research and Evaluation, HealthHIV, Washington, DC
Brian Hujdich, BS , HealthHIV, Washington, DC
Javier Salazar , AETC National Center for HIV Care in Minority Communities, HealthHIV, Washington, DC
     
Background: Dramatic improvements in HIV treatment and biomedical prevention strategies, along with shifts in the healthcare workforce and national efforts to address health insurance coverage (Patient Protection and Affordable Care Act) and improve response to the domestic epidemic (National HIV/AIDS Strategy) have resulted in a rapidly evolving landscape for the communities, providers, and systems delivering HIV care.

Methods: HealthHIV and Medscape hosted an online survey to identify trends in the provision of HIV care among primary care providers and HIV specialists. There were 1,806 respondents who were recruited through open invitations via targeted e-mail lists, monthly newsletters, and postings on websites. Data were collected between July and October 2011.

Results: Concerns over rising HIV caseloads among HIV specialists and insufficient reimbursement for HIV are key drivers in the HIV care landscape. Prescribing clinicians perceive stigma, limited English proficiency, as well as immigration and citizenship as the largest barriers patients face in accessing HIV care. An aging workforce, movement from HIV specialists to primary care providers, lack of provider confidence in treating HIV and co-morbidities, and need for continuing education all continue to impede access to quality HIV care.

Conclusions: HIV primary care providers need timely continuing education opportunities to build confidence in caring for the newly insured, understanding delivery of new biomedical interventions, and in initiating ARV treatment. Additionally, practice transformation and HIV integration capacity building efforts are needed to improve delivery of HIV services across system.

Learning Areas:
Administration, management, leadership
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe the current trends of HIV care in primary care settings in the United States Compare the perceptions of both HIV care providers and non-HIV primary care providers in provider care and concerns related to task shifting Define the current profile of the typical HIV Primary Care Provider in U.S. Articulate the impact of Health Care Reform on both HIV primary care providers and non-HIV primary care providers Understand current provider perceptions of patients’ barriers to HIV care Discuss methods for addressing the fractured HIV care continuum.

Keywords: Health Care, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Policy and Prevention program manager with a national HIV non-profit, providing capacity building to mayors, community health centers, and primary care providers related to HIV prevention, care, and treatment. Fifteen years experience providing research, evaluation, and program implementation to improve access to quality prevention and care services for high risk communities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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