HIV and Health Centers

HRSA-funded health centers play an important role in Ending the HIV Epidemic by serving as a key point of entry for people undiagnosed with HIV. Many health centers provide HIV care services, including Pre-exposure Prophylaxis (PrEP). Health centers emphasize coordinated and comprehensive care, and have the ability to manage patients with multiple health care needs. Integration of HIV testing, prevention, care, and treatment into primary care settings and providing essential enabling services such as outreach, patient education, case management, and care coordination, can increase access and improve health outcomes for patients living with HIV.

According to CDC estimates, more than 1.1 million people in the United States are living with HIV infection, and almost 1 in 7 (15%) are unaware of their infection. Many are members of vulnerable populations and underserved communities.

Health centers report HIV screenings, diagnoses, and linkages to care as part of the Uniform Data System (UDS). According to the 2017 UDS data, over 165,000 patients living with HIV receive medical care services at health centers, including many sites co-funded by the Ryan White HIV/AIDS Program. Health centers provided:

  • more than 1.8 million HIV tests, and
  • an HIV diagnosis to 8,060 patients (between October 1, 2016, and September 30, 2017); approximately 85% of those patients were seen for follow-up treatment within 90 days.

Integrating HIV Services through Partnerships for Care

Integrating HIV services into primary care delivery is critical for success—both for health centers and for patients living with HIV. Partnerships for Care (P4C) was a 3-year demonstration project (2014-2017) in which health centers partnered with the CDC-funded state health departments in Massachusetts, New York, Maryland, and Florida. Project goals were to strengthen the workforce, build infrastructure, and provide HIV services. In fiscal year 2014, 22 health centers received supplemental funding to expand the provision of HIV prevention, testing, and care and treatment services, especially among racial/ethnic minorities.

Outcomes

The P4C project identified promising practices for the integration of HIV services into primary care and for building strong primary care-public health partnerships HRSA BPHC exit disclaimer (PDF - 560 KB) to expand the provision of HIV prevention and care services. Participating health centers expanded their services to:

  • Provide HIV testing to 168,645 patients—a 48.2% increase from 2015 to 2017. This included routine testing of 121,285 previously untested patients.
  • Link 93% of newly HIV-positive patients to HIV care within 90 days of diagnosis. 
  • Show an improving trend in viral suppression rates for patients living with HIV; 79% of these patients were virally suppressed.

The health centers also worked with state health departments (within and across states) to re-engage 1,225 HIV-positive people in care.

P4C Toolkit

The toolkit below captures the resources, tools, and lessons learned from P4C health centers during the project. As health centers integrate HIV and primary care, they may find this information helpful. This three-module toolkit includes case studies and vignettes from P4C grantees, addressing the five P4C focal areas:

  • Workforce development
  • Infrastructure development
  • Service delivery
  • Quality improvement and evaluation
  • Sustainable partnerships

Resources

Health centers interested in expanding HIV-related services, or improving integration of those services into primary care, may benefit from resources developed or used by other health centers.

Date Last Reviewed:  May 2019