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The Spectrum of Engagement in HIV Care at the Northwest Pennsylvania Rural AIDS Alliance. By: Tyler Kitzmiller. What is HIV?. Human Immunodeficiency Virus Causes Acquired Immune Deficiency Syndrome (AIDS) Transferred through sex and blood-to-blood contact 34 million people.
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The Spectrum of Engagement in HIV Care at the Northwest Pennsylvania Rural AIDS Alliance By: Tyler Kitzmiller
What is HIV? • Human Immunodeficiency Virus • Causes Acquired Immune Deficiency Syndrome (AIDS) • Transferred through sex and blood-to-blood contact • 34 million people
National Study on HIV Care • “The Spectrum of Engagement in HIV Care and its Relevance to Test-and-Treat Strategies for Prevention of HIV Infection” – Edward Gardner, et. al. • Looked at the level of engagement in HIV care in the United States • Purpose was to quantify the spectrum of engagement in HIV care. • Wide range of care in the United States
My Project • Northwest PA Rural AIDS Alliance • Comparing the Engagement in Care
Northwest PA Rural AIDS Alliance • Grant-funded program under Clarion University, founded in 1991 • Works to improve the health of underserved people affected by HIV/AIDS. • Provides care and medical case management to patients infected with HIV or co-infected with HIV and HCV. • Serves 13 counties in Northwest PA
Hypothesis & Alternate Hypothesis • Hypothesis • If I compare the rational analysis of the Northwest Alliance with that of the study, the adherence of patients at the Northwest Alliance will be equal to what was found in the national study. • Alternate Hypothesis • If I compare the rational analysis of the Northwest Alliance with that of the study, the adherence of patients at the Northwest Alliance will be less than what was found in the national study.
Why should you care? • Spread of HIV • Undiagnosed patients • Out-of-Care • Non-adherent patients • Medication Resistance
Conclusion • What the Alliance does well: • Linking patients to care • Starting and continuing medication treatment for patients • Areas of Improvement: • Retaining patients in care • Having patients be adherent/undetectable • When I compared the rational analysis of the Northwest Alliance with that of the study, the adherence of patients at the Northwest Alliance was less than what was found in the national study.
Further research • Why are patients not retained in care at the Alliance? • Why are patients not undetectable? • Are there similarities among these patients? • Race/Culture • Language barrier (non-English speaking?) • Gender • Medication • Are the patients attending their regularly scheduled doctor’s visit? • How is the Alliance successful at linking all of their patients to care? • How is the Alliance successful at making sure patients who need to be put on medication are put on medication?
Thank You • Dr. Doug Smith • Dr. Hallie Savage • Leah Magagnotti, BSN • Northwest PA Rural AIDS Alliance • Honors Program
References • Gardner, E. M., M. P. McLees, J. F. Steiner, C. Del Rio, and W. J. Burman. "TheSpectrum of Engagement in HIV Care and Its Relevance to Test-and-TreatStrategies for Prevention of HIV Infection." Clinical Infectious Diseases52.6(2011): 793-800. Print. • "U.S. Statistics." U.S. Statistics. N.p., n.d. Web. 14 May 2013 • Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 23 Apr. 2013. Web. 14 May 2013. • "CD4 Count, HIV, and AIDS: Test and Results -- What They Mean." WebMD. WebMD, 02 Apr. 0004. Web. 14 May 2013. • "HIV Classification: CDC and WHO Staging Systems." HIV Classification: CDC and WHO Staging Systems. N.p., n.d. Web. 14 May 2013. • "Transmission of HIV." Transmission of HIV. N.p., n.d. Web. 14 May 2013. • Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 15 Apr. 2013. Web. 14 May 2013.