London KJ, Indyk D, Dorrell K, Boyer A, Indyk L; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. D12888.
Mount Sinai Medical Center, New York, United States
Issue: The majority of people living with HIV infection are not receiving ongoing primary care. To reduce degrees of separation between infected individuals and available treatment and prevention, innovative approaches engage them where they are physically and reduce barriers to care. Critical masses of marginalized HIV infected individuals with multiple layers of needs can be engaged over time through high touch, low tech, sustained outreach. Outreach workers must be able to navigate multiple systems and contextual environments in order to respond to crises as well as to stimulate readiness for higher threshold care. Description: Health Bridge is a multi-disciplinary low threshold, home-delivered ambulatory care program, linked to tertiary and primary care settings, which reaches and engages out-of-care individuals with co-morbidities of mental illness and addictions. Clinical capacity is brought directly to the "village" by clinicians who in turn are linked to more traditional systems of care. Results: To date, almost 700 individuals with HIV/AIDS who were previously not in care have been clinically assessed, in their home setting. Of these 200 have been hospitalized; 286 were linked to clinic based HIV care; 129 received psychiatric care. Many unwilling to be linked to more traditional systems, consider Health Bridge as their primary source of care. This approach fosters the bottom-up development of a web of linkages among providers, systems and settings. The front line workers include, and are supported by medical and health professionals and a social scientist. Recommendations: Low threshold entry points and harm reduction methods can be supported by a network of highly skilled generalists, and specialists (including psychiatry). We offer this cost-effective door-to-door model for replication and adaptation in both resource rich and resource poor communities. Funded by US/DHHS Ryan White Title I
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Community Health Aides
- Counseling
- Delivery of Health Care
- HIV Infections
- HIV Seropositivity
- Health
- Health Policy
- Health Services
- Health Services Accessibility
- Health Services Needs and Demand
- Humans
- New York City
- Primary Health Care
- Psychiatry
- Research
Other ID:
UI: 102278394
From Meeting Abstracts