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15th Annual Conference of the British HIV Association1-3 April 2009, Liverpool, UK |
TARGETING HARD-TO-REACH GROUPS: MOVING OUTSIDE THE HIV CLINIC
HIV Med 2009 Apr 1-3 (Suppl 1);15:15 (abstract no. P16)
S Creighton
Homerton University Hospital, London, UK
BACKGROUND: Teenagers and intravenous drug users with HIV can find it difficult to attend clinic appointments due to a variety of psychological, social and physical problems. This study describes two community-based HIV clinics aimed at increasing access to HIV care in these two groups.
METHODS: A community-based adolescent centre, offering support for a wide range of social, emotional and physical issues affecting teenagers, established an HIV clinic in January 2008. An HIV consultant worked in conjunction with a range of non-clinicians and general physicians and delivered the full range of outpatient HIV care in a community setting. A similar model was adopted in the substance abuse unit, where an HIV consultant and drug workers worked together to provide complete outpatient HIV care, including directly observed therapy of antiretrovirals alongside methadone replacement therapy
RESULTS: The client numbers accessing the service (No), those fulfilling BHIVA criteria for commencing antiretroviral treatment (Need ART), those receiving HAART (On ART) and those lost to follow-up (Lost) are shown in the table. Illustrative case histories will be provided.
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| Prior to community clinic | After community clinic | |||||||
| No | Need ART | On ART | Lost | No | Need ART | On ART | Lost | |
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| SAU | 38 | 19 | 8 | 14 | 47 | 22 | 20 | 3 |
| teens | 16 | 8 | 5 | 8 | 19 | 8 | 7 | 4 |
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CONCLUSIONS: The community-based clinics were successful at engaging hard to reach individuals and attracted additional clients. The number of clients appropriately starting ART rose from 13/27 to 27/30, and those lost to follow-up reduced from 22 to 7. Although labour-intensive, it appears that offering a holistic model of care by a multi-disciplinary team including non-HIV specialists may be an effective method of targeting hard-to-reach groups.
2009-04-01
P16
Copyright © 2009 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD