Keys to Ensuring Adherence in HIV Treatment and Care

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An HIV diagnosis does not have the same meaning today as when the virus first emerged in the 1980s. People living with HIV can now expect to live a long, full life, as long as they adhere to a prescribed antiretroviral treatment regimen. AIDS Healthcare Foundation (AHF), the largest provider of HIV/AIDS medical care globally, plays a key role in ensuring that people living with HIV can adhere to treatment and stay healthy.

The Role of Adherence in HIV Treatment

In HIV care, adherence is everything.  Staying on one’s HIV medications lowers the amount of HIV present in the blood.  That means the person living with HIV is healthy and can live a full, normal life.  If the level of virus becomes low enough to be undetectable – which it can if the person takes their medications religiously, without fail — the virus can’t be transmitted.  That, in turn, breaks the chain of infection and benefits public health.

Adherence Through Linkage to Care

AHF makes sure people are aware of their HIV status through free, easily available and stigma-free testing as a first step toward achieving treatment adherence for as many people as possible. 

Once someone receives an HIV-positive diagnosis, the AHF Linkage to Care program ensures people take the first step to get linked to the HIV treatment they need for their health and wellbeing and to achieve viral suppression. Linkage specialists link people into HIV care either with a medical provider at an AHF Healthcare Center or another health facility of the person’s choice.  They work with AHF testing programs, community organizations and leaders to find newly diagnosed individuals.  Linkage specialists also help bring people who have fallen out of care back into care.  Because Linkage Specialists “meet the person where they’re at,” they are on-call 24/7 to ensure every newly diagnosed individual has an appointment with a healthcare provider within 72 hours of diagnosis or referral. Everyone linked into AHF care is guaranteed to receive high-quality primary care, regardless of ability to pay.

Adherence Through Pharmacy Services

Specialty pharmacy services offered through AHF Pharmacy are vital to AHF’s adherence strategy. AHF offers easy-to-use packaging that organizes a client’s medication in a user-friendly monthly packet or packaged in individual “to-go” containers that make taking medication fast and easy. This adherence packaging is a special feature of AHF Pharmacy.  

Adherence Through Assistance with Benefits and Social Services

To ensure adherence for as many people as possible, AHF staff members help our clients navigate their HIV care services. Dedicated, trained staff members help clients review all benefits and programs including private insurance, Medicaid, Medicare, and the Ryan White HIV/AIDS Program.  Other staff help people find housing, food, transportation, mental health, and other programs to help them overcome barriers that might keep them from staying adherent to their treatment.

Adherence Through Retention in Care

If the key to HIV care is adherence, then the key to adherence is retention in care.  People living with HIV need regular lab work to check their viral load.  They need to check in with their provider multiple times a year to discuss any changes and address any problems.  People that stop getting labs and stop seeing their provider are at great risk of becoming non adherent to their medications and then becoming sick.

AHF’s commitment to patient retention is demonstrated by its regular patient outreach. AHF Healthcare Center teams work diligently to monitor patients at risk of dropping out of care: those patients who have “no showed” or repeatedly canceled appointments with their medical providers and patients who have not seen their medical providers for more than 90 days. Every AHF Healthcare Center staff member is engaged in connecting and following up with patients, including AHF medical providers who personally call their patients who are at risk of falling out of care.

AHF Healthcare Centers successfully retain people living with HIV in care by focusing on risk factors, surveying client experiences, and training staff in HIV-related stigma and cultural sensitivity.  AHF healthcare centers perform far above the national average when it comes to keeping our patients virally suppressed.

In short, AHF utilizes a comprehensive “one-stop-shop” approach to HIV care to improve client engagement by providing primary care and pharmacy services, benefits counseling, care management services – and even, in some states, specialized health plans for those who qualify.  AHF’s mission is to save and improve as many lives as possible through its delivery of compassionate, non judgemental care–aided greatly by AHF’s innovative and effective adherence programs.  To learn more about AHF, visit: www.aidshealth.org

Laura Boudreau is Chief of Operations/Risk Management and Quality Improvement at AHF. She can be reached at feedback@ahf.org.

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