Abstract
INTRODUCTION: Mississippi has the seventh highest rate of people newly diagnosed with HIV infection, and the city of Jackson - the capital and largest metropolitan area of Mississippi - has the third highest rate of AIDS diagnoses among all metropolitan areas in the nation. Linking patients to care and proper adherence to antiretroviral therapy is important for achieving viral load suppression and reducing transmission of the virus. However, many HIV-infected patients have social and clinical barriers to achieving viral suppression. To overcome these barriers the Open Arms Healthcare Center has implemented an integrated HIV care services model. PURPOSE AND OBJECTIVES: The purpose of this study was to determine whether an integrated model of HIV care influenced linkage to health care, adherence to antiretroviral therapy, and viral load suppression. INTERVENTION APPROACH: The integrated HIV care services model consisted of 5 care coordination components: 1) case management, 2) HIV health care (primary health care), 3) behavioral health care (mental and substance abuse screening and treatment), 4) adherence counseling (a pharmacist-led intervention), and 5) social support services (transportation, emergency food assistance, housing, and legal assistance). EVALUATION METHODS: We used a cross-sectional research design to examine Open Arms electronic health record data collected from 231 patients from January 2015 through December 2017 to determine if an integrated model of HIV care resulted in increased linkage to health care, higher adherence rates, and improved viral load suppression. RESULTS: Findings showed a 38.0% increase in the viral load suppression rate, a 12.8% increase in antiretroviral therapy adherence rate, and an 11.0% increase in retention rates among Open Arms patients receiving integrated HIV care. IMPLICATIONS FOR PUBLIC HEALTH: A comprehensive, holistic approach helps to effectively identify and connect HIV-positive patients to care and relink patients who may have fallen out of care.