October 1, 2013 – the date when the Affordable Care Act’s (ACA’s) marketplaces open for enrollment – is less than four months away, and there is much still be done to ensure a smooth transition to coverage through these marketplaces. The marketplaces, which will allow people to compare and purchase “Qualified Health Plans” (QHPs), provide a tremendous opportunity for people living with HIV to access comprehensive, affordable private insurance – many for the first time. Maximizing access to private insurance will be particularly important in states that do not expand Medicaid in 2014. However, engaging with and navigating the private insurance options will involve new issues and concerns and a new insurance vocabulary. State HIV/AIDS programs, providers, and consumers are considering the following issues and action steps as they prepare for open enrollment:
To date, the 25 year restriction on using federal funds to support needle and syringe service programs (SSPs) is still in place despite an abundance of scientific research showing that this practice significantly reduces the transmission of HIV as well as other infectious diseases. This federal restriction has continued despite the work of national HIV education and prevention programs like the Ryan White HIV/AIDS Program, and in spite of attempts by the Obama Administration to lift the ban.
The PPACA directly impacts the role of social workers, especially those working in HIV care settings. The fluctuating landscape of medical, mental health, and supportive services as a result of the PPACA calls for social workers to be actively engaged in the enhancement of human well-being, to provide access to basic resources, and to ensure that the vulnerable, oppressed, and impoverished are included in an environment in which they feel empowered to achieve self-efficacy.
A health care reform “to do” list was presented about six months ago at the November 2012 Ryan White Grantee Meeting. You may have missed it. In a sea of hundreds of sessions at the biennial conference were 11 grantee workshops on ideas and recommendations for Ryan White agencies to take in 2013 and beyond to implement the Affordable Care Act (ACA). Contract with health plans, revitalize benefits counseling, collaborate with state Medicaid officials on HIV/AIDS care issues - the TARGET Center sorted and captured all these ideas in one place: the ACA and Ryan White Learning Modules. There are just four categories but lots of details under each. They are:
- Learn about Reform
- Engage in Marketplace Planning
- Educate and Assist Clients
- Adjust Systems
HIV-infected persons in the U.S. are increasingly overweight and obese with rates of weight excess similar to the general population. Weight excess in the HIV-infected population is often associated with other medical conditions such as hypertension and high cholesterol, and clinicians should consider including weight management programs as part of routine HIV care.¹ Josephine DiLena is a Registered Dietitian practicing at the François-Xavier Bagnoud (FXB) Center Clinic at The University Hospital in Newark, New Jersey. For seven years she has been caring for HIV-infected men, women and children, offering them nutritional guidance to enhance antiretroviral treatment (ART) and other therapies. Over the years, she has witnessed the changes in weight loss and gain among ART users, so we asked her to share what she believes to be most important for HIV providers to keep in mind when discussing nutrition with their patients.
From the Ryan White All-Grantee Meeting to the International AIDS Conference to the in+care Campaign, from case conferencing to the water cooler, the “treatment cascade” seemed to have everyone, everywhere talking. The numbers were even explored right here on ShareSpot, too! So what can we do to get these hard to reach HIV patients into—or back into—care and treatment?
Among the 1.1 million Americans living with HIV infection in the United States, only 25% are virally suppressed. Depicted as the “treatment cascade,” individuals must navigate a series of steps starting with HIV testing and diagnosis, initial linkage to medical care among those who test positive and subsequent retention in care followed by antiretroviral therapy (ART) receipt and adherence to ultimately achieve viral suppression (Figure 1).
The intersection of opioid abuse, particularly injection drug use, and HIV is well documented and has been since the early days of the epidemic. A newer trend, however, has been nonmedical pain medication abuse.
Receipt of prescription opioids to treat pain is not uncommon, particularly as HIV disease is associated with acute and chronic pain syndromes. Today, thanks to recent legislation, physicians can prescribe buprenorphine to address such opioid abuse.
An increasingly diverse population continues to challenge the American health care system as it struggles to deliver quality health care to all. One consequence of this is increased health disparities and inequities, particularly within racial and ethnic minority communities.