Presentation Title

Increased ER-based HIV screening and Rapid ART initiation model in Western Pennsylvania

Abstract

Allegheny Health Network (AHN), an 8 hospital health system serving a blended urban/rural population, instituted ER-based HIV screening at their flagship hospital. The RW Clinic within AHN started a Rapid ART program, offering same-day ART/linkage for new diagnoses. This presentation focuses on ER-based HIV screening and RAPID ART linkage as a two pillar model of addressing HIV diagnosis, linkage and treatment in the health system.

Proposal Summary

Rapid ART was initiated at the AHN Ryan White Clinic in Pittsburgh, PA in July 2017. Since that time, 30 patients have been enrolled in the program, and 11 of which are from non-urban communities. The median days from diagnosis to intake was 4 days, and days to viral load suppression from intake was 42 days. The program offers same-day appointments and walk in for new confirmed diagnoses, regardless of insurance status or ability to pay, with option for patient to walk out with medication in hand. Center for Inclusion Health, an organization within AHN promoting inclusive health models for marginalized populations, accepted a Gilead FOCUS (Frontlines Of Communities in the United States) grant in September 2016. The Emergency Department at Allegheny General Hospital (AGH) was selected as one of the sites for expanded HIV-screening within the health network. This emergency department serves a wider community of individuals from Ohio, West Virginia, and rural Pennsylvania as a level 1 trauma center. Since the beginning of the program, the Allegheny General Hospital ED has screened 2505 individuals for HIV, identifying 7 new cases of HIV (0.3% prevalence). Zip code level data will be displayed at the poster presentation to highlight the geographic breakdown of the population served at AGH. The future goal of the FOCUS program at AHN is to expand to two other Emergency Departments within the health system which primarily serve rural populations. The goal of these programs is to offer increased access to testing, warm linkage to care, same-day treatment, and retention in care for marginalized populations and rural communities. The theoretical goal is to decrease the community viral load, incidence of new diagnoses, and identify untreated positives through partner notification services. With expansion of the Gilead FOCUS grant throughout the health network hospitals, more rural patients who may utilize the ER in place of primary care services will have access to HIV screening and Rapid ART linkage. Integrating these programs is a two pillar model of addressing HIV in the health network that will provide access to HIV testing and treatment that was previously inaccessible for these populations.

Relevance And Significance

We chose: • Antiretroviral therapies • Access, retention, and care in rural communities Relevance/Significance: The expanded ER-based HIV screening and linkage to Rapid ART programs provides for newly diagnosed patients access to HIV care within the network, including antiretroviral therapies provided to patient regardless of ability to pay or geographic location on the first day. This may decrease the community viral load, improves ART adherence, promotes retention in care, and supports the patient. ASAP ART access preserves immune function, promotes patient choice, and helps to reduce barriers to ongoing HIV care for rural populations

Session Format

Poster Session

Keywords

Rapid ART, expanded HIV screening, linkage to care, retention in care

Publication Type and Release Option

Presentation (Open Access)

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

Increased ER-based HIV screening and Rapid ART initiation model in Western Pennsylvania

Allegheny Health Network (AHN), an 8 hospital health system serving a blended urban/rural population, instituted ER-based HIV screening at their flagship hospital. The RW Clinic within AHN started a Rapid ART program, offering same-day ART/linkage for new diagnoses. This presentation focuses on ER-based HIV screening and RAPID ART linkage as a two pillar model of addressing HIV diagnosis, linkage and treatment in the health system.