Inpatient Interventions for HIV Patients Improves Reengagement Outcomes

Providing multidisciplinary team consultations for HIV patients while they are hospitalized can increase participation in follow-up care, according to results from a study published in AIDS Care on how to reengage patients. Teams should address social and medical barriers for their patients, according to the study authors.¹

The authors noted that hospitalization offers unique opportunities to engage out-of-care individuals with the ultimate goal of improving their HIV outcomes and reducing health disparities.¹

According to the Centers for Disease Control and Prevention (CDC), individuals with HIV deal with significant stigma, including moral judgments and the belief that people deserve to get HIV because of their lifestyle choices. This stigma can result in significantly fewer health care opportunities, because many individuals with HIV continue to face stigma in medical environments.²

The researchers reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. In October 2014, a multidisciplinary HIV consult team was implemented at the hospital, including an HIV specialist, a case manager, and a transitional care nurse.¹ The researchers then compared engagement in care, retention in care, and virologic suppression between the pre- and post-intervention periods and by treatment received.¹

The researchers used the HIV cascade, a model outlining the steps of care that HIV patients go through from initial diagnosis to achieving viral suppression.³

Of 1056 inpatient admissions, the majority were males (69%) and racial/ethnic minorities (55% Black, 23% Hispanic). They found that each step of the HIV care cascade increased after hospitalization for both pre- and post-intervention, but those who received the HIV consult had greater increases in engagement in care and in virologic suppression.

The researchers concluded that implementing a multidisciplinary transitions team improved care and outcomes for HIV patients after hospitalization.

REFERENCES

• Nijhawan A, Bhattatiry M, Chansard M, Zhang S, et al. HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South. AIDS Care. https://www.tandfonline.com/doi/full/10.1080/09540121.2019.1698704. Accessed Jan 15, 2020.
• Facts About HIV Stigma, Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/hiv-stigma/index.html. Accessed Jan 15, 2020.
• The HIV Treatment Cascade; Alert: Global Information and Education on HIV and AIDS. https://www.avert.org/professionals/hiv-programming/treatment/cascade. Accessed Jan 15, 2020.