Primary care is the next frontier when it comes to managing HIV care.
Sebastian Ruhs, MD, PhD, director of Chase Brexton Health Care’s Infectious Diseases Center of Excellence in Baltimore, Maryland, said he is witnessing an uptick in HIV cases among young, healthy adults, and said primary care—not specialty practices—is the place these patients will turn for advice, testing and treatment.
“There is a big movement to get primary care more and more integrated into the care of HIV-positive patients, but also in the preventive aspect and diagnosing more cases,” Ruhs told Medical Economics.
Although the Centers for Disease Control and Prevention (CDC) recommends annual screening for high-risk individuals, many HIV diagnoses are delayed because they don’t seek HIV-specific care or have healthcare provider who takes note of their high-risk behaviors, said Ruhs.
“Testing people who are at risk on a regular basis is important,” he said. “Everyone with HIV who is walking around with a high viral load is at high risk for infecting other people.”
Ruhs said there are 1.1 million new cases of HIV living in the United States, and of those, roughly 150,000 don’t know it. High-risk individuals include men who have sex with men (MSM), individuals with multiple sexual partners regardless of orientation and intravenous drug users.
There is a push to help infected individuals understand their role in preventing further transmission of the virus, Ruhs added, and there is a new worldwide U=U campaign to spread the message. “U=U” stands for “undetectable means untrasmittable.” The campaign centers on educating HIV-positive individuals that they are not contagious with an undetectable viral load.
“We know now that someone who is HIV positive, on medications and undetectable is considered noncontagious,” Ruhs said.
The campaign targets both HIV positive and negative individuals with the goal of decreasing stigmas and raising awareness for compliance with medical regimens.
“In most areas, the total amount of new cases in HIV have been stagnating or slightly going down,” Ruhs said, adding that there have been improvements with outreach. In some pockets of the population, however, this is still not the case.