Ryan white MAI: Using intense, one-on-one health education and coaching to facilitate HIV care utilization

Issue: African-Americans (AA) comprise nearly half (44%) of all new HIV infections but are less likely to access HIV healthcare. AA women bear an increased disease burden, between 5 and 20 times more likely than Hispanic/Latina (H/L) and White (W) women, respectively, to be HIV infected. In general, AA and H/L present late for diagnosis and entry into care, consequently more likely to experience AIDS related illnesses and death. Issues such as stigma, poverty, lack of awareness of HIV status, lack of access to high quality health care, and unstable housing contribute to these disparities. The Ryan White Minority AIDS Initiative (MAI) addresses the HIV care needs of AA and H/L using health educators and community liaisons to improve access and reduce disparities in health outcomes in these populations. Description: The MAI health educator utilized an intense holistic approach to connect three metropolitan area women to HIV care, including adherence education, care facilitation, and individualized supportive measures. Lessons Learned: Consistent HIV education and care facilitation were effective in linkage to and retention in care, resulting in improved lab values, reversal of wasting, vertical exposure without transmission, reduction in substance use, increased self-esteem, and relocation to suitable housing. Recommendations: Individualized HIV education and care facilitation are critical to linkage and retention in care. Direct observation of the home environment may facilitate identification of client needs in general, reducing barriers to care. Collaborative partnerships employing this holistic approach can improve client outcomes, decreasing health disparities experienced by those living with HIV/AIDS.