In its first two years, Partnerships for Care (P4C) has advanced primary care capacity for HIV diagnosis, treatment, and care among Health Resources and Services Administration (HRSA) funded health centers (health centers) and this has already resulted in important gains.
With funding from both the Secretary’s Minority AIDS Initiative Fund (SMAIF) and HRSA, P4C provided 3 years of funding to 22 health centers in four (4) jurisdictions (New York, Maryland, Florida, and Massachusetts) to build capacity and strengthen partnerships between the health centers and state health departments. Through these partnerships, P4C is leveraging the existing primary care infrastructure in health centers to:
- develop and establish new protocols and procedures for integrating routine HIV testing, treatment, and care into primary care;
- enhance the use of data systems for public health follow-up and re-engagement in care;
- build the capacity of the health care workforce; and
- improve HIV outcomes along the continuum of care for disproportionately impacted racial and ethnic minorities.
The SMAIF and HRSA investments enable health centers and state health departments to expand and improve HIV prevention and care services within communities most impacted by HIV. P4C is generating lessons learned for integrating HIV services into primary care to reduce HIV transmission and improve HIV outcomes for patients living with HIV so they can live long and healthy lives, ultimately saving health care dollars.
Since the start of P4C in 2015, important progress has been made. By the end of the project’s second year, the 22 health centers were able to expand their HIV services to:
- Provide HIV testing to 77,347 patients
- Integrate HIV services into primary care and serve 7,427 HIV-positive persons by the second year; 83% of these persons were prescribed antiretroviral therapy.
- Show an improving trend in viral suppression rates for patients living with HIV; 76% of these patients were virally suppressed.
Additionally, health centers participating in P4C have worked with their state health departments to re-engage 857 HIV-positive people in HIV care. These achievements were possible because of P4C investments by SMAIF, HRSA, and the Centers for Disease Control and Prevention (CDC) that fostered new collaborations between participating health centers and state health departments. These unique working relationships have allowed health center patients who have been lost to follow-up to be found (within and across states), contacted, and re-engaged in care, preventing costly illnesses and reducing transmission risk.
The P4C-funded health centers have also implemented routine HIV testing among all patients, including those who may not have been considered to be at risk for HIV. This has resulted in the identification of 259 patients with new diagnoses at the 22 health centers, 86% of whom were linked to HIV care within 90 days. In addition, each health center now has one or more HIV care team members who can provide basic HIV care and treatment directly to patients, and changes to electronic health records have improved delivery, follow-up, and coordination of HIV services. Planned changes will further improve quality of care and service delivery for health center patients living with HIV.
The federal investments for P4C will have important public health impacts, particularly in translating and disseminating key lessons learned through the development of a toolkit that will be available to HRSA-funded health centers and state health departments across the nation.
If you are interested in more information on P4C, for a limited time you can access webinars and other resources at p4chivtac.com.
The authors would like to acknowledge Dr. Nadra Tyus from the Office of Quality Improvement, Bureau of Primary Health Care, Health Resources and Services Administration, for her support in developing this post.