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Providers Weigh In: Prompt, Ongoing HIV Care Critical to Preventing New Infections

Monday, November 28, 2016

About 1.2 million people in the United States are living with HIV, and approximately 12% are unaware of their infection. Of those infected, only 40% are engaged in HIV medical care, 37% are prescribed antiretroviral therapy, and 30% have achieved viral suppression, according to the Centers for Disease Control and Prevention. Put another way: Only three in 10 people living with HIV have the virus under control.

Dr. Richard Novak
Dr. Richard Novak
Division of Infectious Diseases

This underscores the importance of continued and intensified efforts to reach more people for testing and to make sure that those who test positive for HIV receive prompt, ongoing care and treatment to help them live longer, healthier lives and prevent the spread of HIV to others.

“Recent scientific evidence shows that for an HIV-positive person with suppressed viral load, the risk of transmitting virus to others is reduced by 94% with effective antiretroviral therapy,” says Dr. Richard Novak, chief of the Division of Infectious Diseases at UI Health and director of the UI Health Community Clinic Network (UCCN). “But only 30% of Americans with HIV infection have a suppressed viral load. If we can increase the proportion of individuals who have suppressed the virus, we can prevent the majority of new infections. Once patients are in care and on therapy, we know the medicines work. The challenge is to confront the earlier steps of getting patients from diagnosis and awareness into care and then helping to keep them in care.”

There are many challenges and barriers to successful engagement and retention in care for individuals living with HIV. In addition to medical care, newly diagnosed individuals often need a host of social services and case management.

“It is critical that we as providers help ensure access to services for common conditions like mental health disorders or substance use disorders and address critical factors like housing, transportation, and food insecurity.” Novak says.

The UCCN, in collaboration with Project HEAL (HIV & HCV Screening. Education. Awareness. Linkage to Care) initiative at UI Health, is committed to improving outcomes at every stage of the HIV continuum of care. Over the last two years, the Emergency Department (ED) at UI Health has committed itself to routine HIV screening and linkage to care.

  • Between November 2014 and November 2016, UI Health screened 12,668 patients for HIV in the ED. Twenty-six patients were newly diagnosed with HIV in the ED, and 20 newly diagnosed patients were linked to HIV medical care.
  • A pilot intervention was tested in the ED from August 2015 to March 2016 to identify UI Health patients with HIV who are out of care and re-engage them in care. Fifty-nine HIV positive patients completed an HIV Care Assessment to determine care status, barriers to care, and psychosocial needs. Among those, 15 patients were identified as “out of HIV care” and eight were successfully re-engaged in HIV care.

The UI Health Community Clinic Network utilizes a collaborative, multidisciplinary team of physicians, nurse clinicians, pharmacists, mental health professionals, and outreach workers to offer quality patient-centered care. For more information, visit the UCCN.