Linking recently diagnosed HIV-positive persons to medical care: perspectives of referring providers

Abstract

Background. Quantitative results from clients participating in the Antiretroviral Treatment Access Studies–II (ARTAS-II) intervention have previously been published. The current report provides qualitative data from providers (agency staff who referred clients to ARTAS-II) concerning how the introduction of ARTAS-II case managers affected referrals to HIV care.

Methods. Referring providers from agencies that conducted HIV counseling and testing (community organizations, health care clinics, hospitals, and public health agencies) that had been asked to refer recently diagnosed HIV-positive individuals to ARTAS-II participated. Five ARTAS-II sites interviewed a total of 18 providers using a survey instrument of 11 open-ended questions. The questions covered interviewee characteristics (e.g., how long have you been in this position, job title) and questions related to the ARTAS-II project (e.g., before ARTAS-II, how did you link clients? what benefits have come from being part of the ARTAS-II program?)

Results. Prior to the ARTAS-II project, the referring providers described the referral process as ranging from uncertain to disorganized and chaotic. Referring providers reported the process improved dramatically following implementation of the project, with the transition from HIV testing to medical care becoming less complicated and less prone to delays. Recommendations from the providers for further improvement included increasing the number of ARTAS-II case managers, having the program staff use direct, face-to-face communication with staff at referring agencies, and increasing system integration by having ARTAS-II program staff be co-located in clinic settings.

Conclusion. The introduction of ARTAS-II case managers to receive referrals from HIV counseling and testing programs was widely viewed as a success by referring providers. ARTAS-II case managers were reported to fill a much needed role that strengthened the HIV service delivery system.

Keywords:

• HIV
• linking to medical care
• referring providers
• case management

Acknowledgements

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.