1524. Extending The Continuum Of Care – HIV Primary Care By The Infectious Disease Physician
Session: Poster Abstract Session: HIV: Clinical Care
Friday, October 28, 2016
Room: Poster Hall
Background:

HIV infected (HIV+) patients are increasingly affected by HIV associated non-AIDS conditions. Infectious diseases (ID) physicians are now faced with the task of providing primary care in addition to HIV services to HIV+ patients. The objective of this study is to assess ID physician’s practices and barriers to delivery of primary care services to the HIV+ population.

Methods:

IDSA’s Emerging Infections Network (EIN) is a provider-based emerging infections sentinel network of ID physicians who provide clinical care.

A 6 item survey was used to assess practice patterns and barriers to providing primary care for HIV+ patients. The survey was distributed to EIN members in January 2016.

Results:

Of the 1,248 active members, 644 (52%) responded to the survey. Among the 644 respondents, 431 (67%) routinely treat HIV patients in outpatient settings. Of these 431 respondents, a majority (326, 75%) acted as primary care physicians for at least some of their HIV+ patients. Responders who reported always or mostly performing a screening assessment as recommended per guidelines were: 1) Primary care related screening (fasting lipids 94%, colonoscopy 94%, mammogram 89%, cervical pap smears 87%, depression screening 57%, osteoporosis for postmenopausal women 55% and men >50yrs 23% prostate cancer 37%); 2) Screening specific to HIV (Latent tuberculosis 95%, genital chlamydia/gonorrhea 77%, hepatitis C 67%, extra genital chlamydia/gonorrhea 47%, baseline anal pap smear for men 33% and women 36%); 3) Vaccination related (influenza 99%, PPSV23 96%, PCV13 94%, Tdap 84%, HPV 61% and zoster 39%).

The most common barriers to primary care preventive services were: non adherence to HIV medications (43%), having other health priorities (44%), not enough time for clinic visit (43%) and financial or insurance limitations (40%).

Conclusion:

Most ID/HIV providers act as primary care providers for their HIV infected patients. Provision of primary care screening services and vaccination for HIV+ patients is suboptimal based on current guidelines, and multiple patient and health systems barriers are common. Interventions to increase screening practices and vaccinations; and to decrease barriers are urgently needed to address the needs of the HIV+ population.

Seetha Lakshmi, MD1, Susan E. Beekmann, RN, MPH2, Philip M. Polgreen, MD2, Allan Rodriguez, MD1 and Maria Alcaide, MD1, (1)Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, (2)Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA

Disclosures:

S. Lakshmi, None

S. E. Beekmann, None

P. M. Polgreen, None

A. Rodriguez, None

M. Alcaide, None

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