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Hiv medical home model

Mariana Sarango, Alexander de Groot, Melissa Hirschi, Chukwuemeka Anthony Umeh, Serena Rajabiun
CONTEXT: People living with human immunodeficiency virus (HIV) (PLWH) who are most at risk for falling out of HIV primary care and detectable viral loads include homeless and unstably housed individuals and those codiagnosed with behavioral health disorders. The patient-centered medical home (PCMH) is a model that promotes provision of comprehensive, patient-centered, accessible, coordinated, and quality care for patients. This initiative provided patient navigation to HIV-positive homeless and unstably housed individuals codiagnosed with a mental health or substance use disorder as a means to create an adapted PCMH to meet the specific needs of this population...
January 11, 2017: Journal of Public Health Management and Practice: JPHMP
Lisa E Cox, Mark Brennan-Ing
Older people living with HIV are increasingly requiring formal supportive community-based services. Supportive services are essential to medical care and treatment for older people living with HIV/AIDS. This chapter considers Andersen's behavioral model of health services, and explores the predisposing, enabling, and need factors that affect service utilization among the older HIV population. The Andersen model provides a lens to understand the need for supportive services to go beyond primary medical care...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
Katrina D Hermetet-Lindsay, Katharine F Correia, Paige L Williams, Renee Smith, Kathleen M Malee, Claude A Mellins, Richard M Rutstein
Among perinatally HIV-infected (PHIV) and perinatally HIV-exposed, uninfected (PHEU) youth, we evaluated the contributions of home environment, psychosocial, and demographic factors and, among PHIV only, HIV disease severity and antiretroviral treatment (ART), to cognitive functioning (CF) and behavioral functioning (BF). A structural equation modeling (SEM) approach was utilized. Exploratory factor analysis was used to reduce predictor variables to major latent factors. SEMs were developed to measure associations between the latent factors and CF and BF outcomes...
July 30, 2016: AIDS and Behavior
Leah Karliner, Angela Marks, Sunita Mutha
Despite improvements in overall health of the American population, disparities persist, particularly for minority women. The Affordable Care Act (ACA) offers the potential to reduce disparities through expanded insurance coverage, greater access to high-quality care, and bolstered prevention efforts in the context of new models of care such as the patient-centered medical home (PCMH). We use case studies representing three clinical conditions (breast cancer, HIV, and coronary heart disease) to present strategies for how a PCMH could reduce disparities for minority women...
2016: Journal of Health Care for the Poor and Underserved
Amy Hawkins, Michael Evangeli, Kate Sturgeon, Marthe Le Prevost, Ali Judd
Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently...
2016: AIDS Care
Carlos Roncero, Raquel Domínguez-Hernández, Tomás Díaz, José Manuel Fernández, Rafael Forcada, José Manuel Martínez, Pedro Seijo, Antonio Terán, Itziar Oyagüez
The objective was to estimate the annual interaction management cost of agonist opioid treatment (AOT) for opioid-dependent (OD) patients with buprenorphine-naloxone (Suboxone®) (B/N) or methadone associated with concomitant treatments for infectious (HIV) or psychiatric comorbidities. A costs analysis model was developed to calculate the associated cost of AOT and interaction management. The AOT cost included pharmaceutical costs, drug preparation, distribution and dispensing, based on intake regimen (healthcare center or take-home) and type and frequency of dispensing (healthcare center or pharmacy), and medical visits...
September 15, 2015: Adicciones
Paul K Drain, Elena Losina, Sharon M Coleman, Laura Bogart, Janet Giddy, Douglas Ross, Jeffrey N Katz, Ingrid V Bassett
Poor social support and mental health may be important modifiable risk factors for HIV acquisition, but they have not been evaluated prior to HIV testing in South Africa. We sought to describe self-perceived mental health and social support and to characterize their independent correlates among adults who presented for voluntary HIV testing in Durban. We conducted a large cross-sectional study of adults (≥18 years of age) who presented for HIV counseling and testing between August 2010 and January 2013 in Durban, South Africa...
2015: AIDS Care
Carla S Alexander, Gregory Pappas, Anthony Amoroso, Mei Ching Lee, Yvonne Brown-Henley, Peter Memiah, Joseph F O'Neill, Olivia Dix, Robert R Redfield
Palliative care (PC), introduced early in the management of chronic illness, improves patient outcomes. Early integration of a palliative approach for persons with HIV has been documented to be effective in identifying and managing patient-level concerns over the past decade in African settings. The experience of implementing PC in multiple African and other resource-constrained settings (RCSs) emphasizes the need for essential palliative competencies that can be integrated with chronic disease management for patients and their families facing life-limiting illness...
September 2015: Journal of Pain and Symptom Management
A K Gupta, C R Garg, B C Joshi, N Rawat, V Dabla, A Gupta
In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines...
2015: AIDS Care
Erin Gael Friedman, Megan Crowley, Kim Ammann Howard, M Paoloma Pavel
This article details the processes and findings of a 3-year demonstration project implementing population health management and the Patient-Centered Medical Home (PCMH) model in 3 community health centers in Alameda County, California. The article provides a first look at the PCMH Continuum, a tool for aiding staff in conceptualizing and implementing complex organizational change. Findings of the project evaluation also are shared, comprising a road map for other organizations looking to implement population health management, panel management, and PCMH...
October 2015: Population Health Management
Becky L Genberg, Violet Naanyu, Juddy Wachira, Joseph W Hogan, Edwin Sang, Monicah Nyambura, Michael Odawa, Corey Duefield, Samson Ndege, Paula Braitstein
BACKGROUND: Few population-based studies exist on the HIV care continuum in sub-Saharan Africa. We aimed to describe engagement in care in all adults with an existing diagnosis of HIV and to assess the time to and predictors of linkage and engagement in adults newly diagnosed via home-based counselling and testing (HBCT) in a high-prevalence setting in western Kenya. METHODS: Data were derived from AMPATH (Academic Model Providing Access to Healthcare), which has provided HIV care in western Kenya since 2001 and the HBCT programme, which has been operating since 2007...
January 2015: Lancet HIV
Sean J Haley, Mary Jeanne Kreek
Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen...
March 2015: American Journal of Public Health
(no author information available yet)
The National Center for Biotechnology Information (NCBI) provides a large suite of online resources for biological information and data, including the GenBank(®) nucleic acid sequence database and the PubMed database of citations and abstracts for published life science journals. Additional NCBI resources focus on literature (Bookshelf, PubMed Central (PMC) and PubReader); medical genetics (ClinVar, dbMHC, the Genetic Testing Registry, HIV-1/Human Protein Interaction Database and MedGen); genes and genomics (BioProject, BioSample, dbSNP, dbVar, Epigenomics, Gene, Gene Expression Omnibus (GEO), Genome, HomoloGene, the Map Viewer, Nucleotide, PopSet, Probe, RefSeq, Sequence Read Archive, the Taxonomy Browser, Trace Archive and UniGene); and proteins and chemicals (Biosystems, COBALT, the Conserved Domain Database (CDD), the Conserved Domain Architecture Retrieval Tool (CDART), the Molecular Modeling Database (MMDB), Protein Clusters, Protein and the PubChem suite of small molecule databases)...
January 2015: Nucleic Acids Research
Rehana A Salam, Sarah Haroon, Hashim H Ahmed, Jai K Das, Zulfiqar A Bhutta
In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence...
2014: Infectious Diseases of Poverty
Samuel Kalibala, Waimar Tun, Peter Cherutich, Anne Nganga, Erick Oweya, Patricia Oluoch
Health care workers (HCWs) in sub-Saharan Africa are at a high risk of HIV infection from both sexual and occupational exposures. However, many do not seek HIV testing. This paper examines the acceptability of an unsupervised facility-based HIV self-testing (HIVST) intervention among HCWs and their partners and factors associated with uptake of HIVST among HCWs. HCWs in seven large Kenyan hospitals were invited to participate in pre-HIVST information sessions during which they were offered HIVST kits to take home for self-testing...
July 2014: AIDS and Behavior
Gregory Pappas, Jia Yujiang, Naomi Seiler, Mary-Beth Malcarney, Katherine Horton, Irshad Shaikh, Gunther Freehill, Carla Alexander, Mohammad N Akhter, Julia Hidalgo
To strengthen the quality of HIV care and achieve improved clinical outcomes, payers, providers, and policymakers should encourage the use of patient-centered medical homes (PCMHs), building on the Ryan White CARE Act Program established in the 1990s. The rationale for a PCMH with HIV-specific expertise is rooted in clinical complexity, HIV's social context, and ongoing gaps in HIV care. Existing Ryan White HIV/AIDS Program clinicians are prime candidates to serve HIV PCMHs, and HIV-experienced community-based organizations can play an important role...
July 2014: American Journal of Public Health
Sheena Castelino, Hamida Miah, Vivian Auyeung, Florian Vogt
The aim of this study was to evaluate whether the change in the mode of supply of HIV medicines to a homecare model was associated with any change in adherence and patient outcomes. We conducted a retrospective analysis of medical records of 100 patients who received supplies from a clinic-based hospital HIV pharmacy and 100 patients who were started on home delivery over a three-month period and were followed up over six months. Data on patient demographics, type of HIV drug regimen, HIV viral load, CD4% and adherence status were analysed...
February 2015: International Journal of STD & AIDS
Gemmae M Fix, Steven M Asch, Hemen N Saifu, Michael D Fletcher, Allen L Gifford, Barbara G Bokhour
BACKGROUND: With the reorganization of primary care into Patient Aligned Care Teams (PACT) teams, the Veteran Affairs Health System (VA) aims to ensure all patients receive care based on patient-centered medical home (PCMH) principles. However, some patients receive the preponderance of care from specialty rather than primary care clinics because of the special nature of their clinical conditions. We examined seven VA (HIV) clinics as a model to test the extent to which such patients receive PCMH-principled care...
July 2014: Journal of General Internal Medicine
Eta S Berner, Midge N Ray, Anantachai Panjamapirom, Richard S Maisiak, James H Willig, Thomas M English, Marc Krawitz, Christa R Nevin, Shannon Houser, Mark P Cohen, Gordon D Schiff
BACKGROUND: To improve and learn from patient outcomes, particularly under new care models such as Accountable Care Organizations and Patient-Centered Medical Homes, requires establishing systems for follow-up and feedback. OBJECTIVE: To provide post-visit feedback to physicians on patient outcomes following acute care visits. DESIGN: A three-phase cross-sectional study [live follow-up call three weeks after acute care visits (baseline), one week post-visit live call, and one week post-visit interactive voice response system (IVRS) call] with three patient cohorts was conducted...
August 2014: Journal of General Internal Medicine
Nathaniel Chishinga, Peter Godfrey-Faussett, Katherine Fielding, Helen Ayles
BACKGROUND: The success of adherence to combination antiretroviral therapy (ART) in sub-Saharan Africa is hampered by factors that are unique to this setting. Home based interventions have been identified as possible strategies for decentralizing ART care and improving access and adherence to ART. There is need for evidence at individual- or community-level of the benefits of home-based interventions in improving HIV suppression in African patients receiving ART. METHODS: We conducted a systematic review and meta-analysis of the literature to assess the effect of home-based interventions on virologic outcomes in adults receiving ART in Africa...
March 7, 2014: BMC Public Health
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