Presentation Title

Empowering Family Physicians to Control HIV Infection in Rural Communities

Abstract

Rural communities often lack providers who are comfortable caring for people living with HIV/AIDS (PLWHA). Family physicians are ideal providers to engage communities in HIV prevention, and care for PLWHA in areas that lack access to specialists. We implemented a comprehensive HIV management model into our residency curriculum to prepare residents to manage HIV in rural primary care settings.

Proposal Summary

Georgia has the second highest rate of HIV diagnoses in the United States at 31.8 per 100,000 people. Aside from cities in the Atlanta metropolitan area, Savannah has the next highest rate of HIV diagnoses compared to any other city in Georgia. Memorial University Medical Center (MUMC)—the safety net hospital system for southeast Georgia—implemented an opt-out universal HIV screening program [the CARE initiative] for patients >age 13 in its Emergency Department (ED) in Savannah, GA. Our Emergency Department (ED) supports over 100,000 annual patient visits and serves a spectrum of urban to extreme rural populations, over a third of whom are underinsured or uninsured and utilize the ED for primary care needs. The HIV-positive patients and identify previously diagnosed patients who had not been receiving care for their HIV infection. In addition to diagnosing HIV infection, our objective was to link patients to care in their communities, identify high-risk negative individuals, and offer education about HIV prevention (including information on access to pre-exposure prophylaxis [PrEP]). Since the program’s inception, 46 HIV-positive patients were from rural counties in Georgia but only 4% received treatment in rural areas, demonstrating the need for HIV care and prevention services in rural areas. There was also a significant shortage of healthcare providers who offered PrEP services to high-risk individuals. While some patients have been objective of the CARE initiative is to utilize an electronic medical record (EMR)-based algorithm to identify unknown successfully linked to care in rural communities, others delay treatment due to stigma associated with Ryan White funded clinics. Our affiliated family medicine residency program trains PCP, the majority of whom practice in underserved and rural communities in Georgia. This component of the physician workforce seemed to be an ideal group to address the need for HIV prevention and treatment services in rural areas that lack access to infectious disease specialists. We were able to overcome our residents’ fear of being ill-equipped to treat HIV due to perceived complexity of the disease and treatment through the implementation of a comprehensive prevention and management curriculum.

Relevance And Significance

HIV/AIDS is a disease that knows no boundaries. As such, it is important that the next generation of medical providers are equipped and empowered to treat HIV in underserved areas, like rural communities. By providing education to providers, we increasing access to HIV/AIDS care in the areas where care is needed the most.

Session Format

Poster Session

Keywords

HIV, graduate medical education, routine opt-out screening, emergency department, linkage

Publication Type and Release Option

Presentation (Open Access)

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Sep 21st, 5:30 PM Sep 21st, 7:30 PM

Empowering Family Physicians to Control HIV Infection in Rural Communities

Rural communities often lack providers who are comfortable caring for people living with HIV/AIDS (PLWHA). Family physicians are ideal providers to engage communities in HIV prevention, and care for PLWHA in areas that lack access to specialists. We implemented a comprehensive HIV management model into our residency curriculum to prepare residents to manage HIV in rural primary care settings.