This policy paper sets forth a comprehensive HIV care model that the authors believe addresses the complex medical and psychosocial needs of persons living with HIV.
Essential aspects of effective HIV care include: increased HIV testing within communities, efficient linkage to HIV primary care and specialty care, access to HIV medications, medication adherence support, efforts to retain patients in care, and social services that address the unmet psychosocial needs of HIV-infected patients – all of which must be integrated. This policy paper propses that this integration may be achieved through the "medical home" model in which access to primary care, specialty care, psychosocial services, and social services are coordinated and monitored by an HIV primary care team. The extent and type of care integration may vary according to a patient or patient population's needs. Quality assurance mechanisms, electronic health records, and financial viability are also key components of effective integrated HIV care. However, the authors here do not address serious concerns about privacy breaches in electronic health record systems, which could, among other things, undermine patient confidence in the system and drive them from care.
The authors encourage Medicaid, Medicare, and private insurers to incorporate and strengthen the best aspects of this model. Health care reform under the Affordable Care Act and continued existing funding (e.g., Ryan White program) may make it possible to improve health outcomes of persons living with HIV and prevent new infections.