Haikalis S; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuOrD389.

S. Haikalis, San Francisco AIDS Foundation, PO Box 426182, San Francisco, CA 94142-6182, United States, Tel.: +1 415 487 80 26, Fax: +1 415 487 80 09, E-mail: shaikali@sfaf.org

Issues: San Francisco offers comprehensive health & social services to its 15,000 HIV+/AIDS residents. The healthcare system includes primary medical, OPD, hospital, hospice & medications. A public health system provides free care for HIV+ residents without health insurance. The San Francisco AIDS Foundation (SFAF) is the city's largest AIDS Social Services agency. The majority of the 2500 clients seen last year were poor, people of color, substance users, mentally ill & frequently homeless. Over 90%, however, had a primary medical provider. Despite this comprehensive system of services, there has been a concern that triply diagnosed clients continued to have difficulty in accessing & adhering to HAART. Project: To address this problem, SFAF developed 2 programs for this population to improve adherence to HAART. In the traditional case management model, clients see a case manager weekly & have access to a treatment advocate & support groups. Clients are linked to other community-based support services. At Action Point Adherence Project - a collaboration between SFAF & SFDPH - the focus is on clients who need a more structured program: 98% use substances, 70% have a concurrent mental health issue & most have a lengthy homeless/incarceration history. AP, working from a storefront, provides nursing, case management, part-time acupuncture, pharmacist & needle exchange to 100 clients 6 days/week. Incentives, pagers, a multi-disciplinary team & individualized care plans provide the structure needed. Lessons Learned: Optimum medication adherence can be achieved in a triply diagnosed HIV+ population. Improvement occurs when a client connects to a case manager & acknowledges the need to reduce substance use (particularly crack & speed) and/or accepts mental health treatment. Relapse planning for substance-using clients must be a part of any care plan.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Case Management
• Delivery of Health Care
• HIV Infections
• HIV Seropositivity
• Health Services
• Health Services Needs and Demand
• Humans
• Mental Disorders
• San Francisco
• Social Work
• Substance-Related Disorders
• diagnosis
• therapy

Other ID:

• GWAIDS0001986

UI: 102239479

From Meeting Abstracts