Community support key to managing chronic HIV

Thanks to effective new treatments, fewer people are dying of HIV/AIDS, transforming the disease from a fatal, acute process to a chronic one. These patients, however, through their disease process or other disabilities and deficits, may find it difficult to live with some of the challenges a chronic HIV diagnosis can bring.

Healthcare teams provide the frontline medical care these patients need to live, but it is community programs, like those offered by the Ryan White HIV/AIDS Program, Save the Children and more, that offer services of daily support.

There are many programs offered by government and charitable organizations, but there are still hurdles to access those services. Margaret Hoffman-Terry, MD, FACP, AAHIVS, chair of the National Board of Directors for the American Academy of HIV Medicine, told Medical Economics that while many of these those programs are offered for free or at reduced costs, location and accessibility can be an issue.

“Those who have good access to transportation and resources within easy travel distance are most likely to access them,” Hoffman-Terry said. “Many programs, like the Ryan White clinic where I work, are able to provide bus passes.”

Patients are best served by community programs that offer multiple services at a single location, she said.

“One-stop shopping, where case management providing referrals/access to community services, is often the best approach, as patients will see their healthcare team and their case management team on the same day so their insurance can be updated and referrals made to food banks, mental health, shelters, and more,” Hoffman-Terry said.

The most successful community programs usually offer the help of a multi-disciplinary team, as well. The combined efforts of primary care providers, nurses, pharmacists, dieticians and case managers working together is most helpful in achieving good outcomes over a lifetime of living with HIV, Hoffman-Terry said.

Next: The role of primary care

Primary care connectors

Primary care physicians play an important role in referring patients-particularly those who are newly diagnosed-to local resources that can help them manage their appointments, medications, activities of daily living, social needs and more on a day-to-day basis.

“Referrals to their local AIDS service organizations are crucial to those in need of assistance, which in many practices is the majority of patients,” Hoffman-Terry said. “Keeping a list updated and available to patients that includes local, state and national resources is often a great help.”

Some of the most effective and commonly found programs that PCPs can refer patients to for help include specific local AIDS services organizations, food banks and soup kitchens, shelters, legal aid organizations, local health departments, women’s clinics, LGBT community centers, community mental health services, housing services and substance abuse programs

Additionally, Hoffman-Terry said the American Academy of HIV Medicine has a comprehensive database of HIV care providers across the country. The Referral Link directory allows users to search for providers by zip code within a certain radius, and also includes information on medical services provided, specialty care, case management, substance abuse, pre- and post-exposure prophylaxis, and support services such as hospice, clinical trials, ministry and bilingual services.