Case Management Interventions for HIV-Infected Individuals

Abstract

Engagement of HIV-positive persons into care and achieving optimal antiretroviral treatment outcomes is a fundamental HIV prevention strategy. Case management model was recommended as a beneficial model of care for patients with a new HIV diagnosis, focusing on individuals with unmet needs, and linking them with the coordinated health and social services to achieve desired outcomes. HIV case management is population-driven and programs are designed to respond to the unique needs of the client population they serve, such as substance users, homeless, youth, and prison inmates. This view found 28 studies addressing effectiveness and impacts of case management intervention for people living with or at risk of HIV/AIDS. Effectiveness of case management intervention was categorized as follows: decreased mortality and improve health outcomes, linkage to and retention in care, decreased unmet needs, and reducing risky behaviors.

Sexual Risk Reduction for HIV-Infected Persons: A Meta-Analytic Review of “Positive Prevention” Randomized Clinical Trials

“…Positive prevention has three complementary objectives in HIV-infected individuals: (1) reducing high risk sexual behaviors; (2) reducing injection and non-injection drug and alcohol abuse, where relevant; and (3) optimizing clinical care [5]. The last objective seeks to: (i) foster linkage and retention of HIV-infected persons to good care; (ii) enhance coverage and adherence to antiretroviral therapy (ART); (iii) increase full suppression of HIV viral load; and (iv) prevent development of HIV drug resistance [6], [7].…”

Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis

“…Despite evidence of increased rates of HIV-related complications after release from prison, many studies have identified effective mechanisms for health maintenance, including case management, 41 discharge planning, 10 transitional care coordination, 42 and focusing on combined medical and social needs. 43 Findings from a single randomised trial did not find a benefit in the use of case management for released prisoners with HIV; however, these findings may be unique to the particular setting.…”

A Prospective Study of Interactions Between a Case Management Program and Retention in Care on HIV Suppression in Taiwan, 2008–2012

“…1 Case management (CM) has been shown to facilitate entry and engagement in care among persons living with HIV. 2,3 In the United States, HIV CM is a federally legislated program funded by the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 (now the Ryan White Treatment Modernization Act). Japan, Brazil, and Rwanda have also initiated a integrated case management program by the government.…”

“…Japan, Brazil, and Rwanda have also initiated a integrated case management program by the government. 3 HIV-infected patients in Taiwan have been provided with free antiretroviral therapy and medical care at AIDS-designated hospitals since the early 1990s. An estimated 70% of individuals living with HIV infection in Taiwan have sought HIV care, and 40% of individuals who have sought HIV care received HAART after the diagnosis of HIV infection with CD4 cell counts < 350 cells/mm.…”

“…An estimated 70% of individuals living with HIV infection in Taiwan have sought HIV care, and 40% of individuals who have sought HIV care received HAART after the diagnosis of HIV infection with CD4 cell counts < 350 cells/mm. 3,4 In 2005, the Taiwan Center for Disease Control (Taiwan CDC) initiated an HIV case management (CM) program in AIDS-designated hospitals to provide integrative services and risk reduction counseling for HIV-infected individuals. The current study provides a unique opportunity to observe the impact of HIV case management on achieving the optimal therapeutic effect of HAART among HIV-infected persons.…”