Below are links to publicly available resources focused on improving integration of HIV prevention, care, and treatment into primary care health centers; and building sustainable partnerships between health centers and health departments.
AIDSinfo released an HIV/AIDS app for federally approved HIV/AIDS medical practice treatment guidelines that HIV providers and other health professionals can access through iOS and Android devices. The guidelines include up-to-date recommendations on the treatment of HIV in adults, adolescents, and children and the management of mother-to-child transmission. Download the app.
The AIDSinfo HIV/AIDS Drug Database app provides access to the same drug information provided by the AIDSinfo Drug Database. The app includes two versions of each drug summary—one for consumers (English and Spanish) and one for health care professionals. The app automatically refreshes content, so the information is always up to date. Download the app for iOS and Android devices.
The Clinician Consultation Center provides rapid expert consultation and advice on management of HIV/AIDS, perinatal HIV, pre-exposure prophylaxis, and post-exposure prophylaxis management for HIV and hepatitis B and C. The clinical consultants are HIV-treatment experienced physicians, clinical pharmacists, nurses, and NPs from the University of California, San Francisco.
The HHS Panel on Antiretroviral Guidelines for Adults and Adolescents announces the release of the updated Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Key updates to the guidelines include additions and changes to the following guideline sections: What to Start; Management of the Treatment-Experienced Patient; Drug Interactions; Acute/Early HIV Infection; HIV-2 Infection; and HIV/Hepatitis C Virus (HCV) Coinfection. For a complete preview of key updates to the guidelines, please see What's New in the Guidelines. Additions and revisions are also highlighted in yellow throughout the text and tables of the PDF version of the guidelines.
The HIV Web Study site, developed by Northwest AIDS Education and Training Center and the University of Washington, includes case based modules and interactive tutorials for health-care workers involved with the clinical care of HIV-infected individuals.
The American Academy of HIV Medicine, in partnership with the Centers for Disease Control and Prevention (CDC), and the American Medical Association (AMA), developed the Coding Guide for Routine HIV Testing, which provides background on the CDC's 2006 Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings as well as patient examples, and the coding information for the Medicare HCPCS codes for HIV testing; CPT Codes for HIV test products, test administration, and office services; and ICD-9 CM diagnosis codes.
HealthHIV’s National Center for Health Care Capacity Building developed the “Maximizing Third Party Reimbursement through Enhanced Medical Documentation and Coding” Series, a four-part webinar series for the enhancement of third party billing systems to maximize revenues. This series is intended for administrators and medical billing specialists.
Data to Care is a new public health strategy that aims to use HIV surveillance data to identify HIV-diagnosed individuals not in care, link them to care, and support the HIV Care Continuum. Information and resources can be accessed through the Data to Care section of the Centers for Disease Control and Prevention (CDC) Effective Interventions website. Additional resource are listed below.
Webinar - Data to Care: Using HIV Surveillance Data to Support the HIV Care Continuum, National Alliance of State and Territorial AIDS Directors (NASTAD)
Data to Care Webinar [PDF]
Partnerships between Federally Qualified Health Centers and Local Health Departments for Engaging in the Development of a Community-Based System of Care, developed by the National Association of Community Health Centers, provides information on federally qualified health centers and local health departments and explores various collaborative models that optimize resources and promote improved health care access and quality improvement.
The Health Resources and Services Administration’s (HRSA) HIV/AIDS Health IT Adoption Toolbox was designed to serve the HIV/AIDS Bureau (HAB) community and other HIV/AIDS care providers. It is a supplement to the Health IT Adoption Toolkit, which targets HRSA broader audience of community health centers, other safety net providers, and ambulatory care providers. While the information and resources in the Health IT Adoption toolkit are relevant to those providing HIV/AIDS care, this HIV/AIDS Health IT Adoption Toolbox addresses issues that are specific to HIV/AIDS providers and the patients they serve.
The HHS Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents include Considerations for Antiretroviral Use in Patients with Coinfections. Guidelines are provided for the use of ARVs in patients with hepatitis C and hepatitis B.
HepCure is a free provider and patient education toolkit, which uses web-based and smartphone-enabled resources, navigation, consultation, and support to enhance the quality of care for persons living with HCV. The Icahn School of Medicine at Mount Sinai in New York City developed the HepCure toolkit for HCV in collaboration with the New York State Department of Health’s AIDS Institute and the Community Health Care Association of NYS (CHCANYS) along with their member community health centers.
The American Association for the Study of Liver Diseases (AASLD) released updated guidelines for the treatment of chronic hepatitis B infection. Developed and disseminated by AASLD, a professional society of scientists and health care professionals committed to preventing and curing liver disease, the new guidelines are an important tool to support clinical decision making for health care providers who care for individuals infected with hepatitis B.
The Affordable Care Enrollment TA Center, ACE On the Go, podcast series for HIV Clinicians was developed by the ACE TA Center, in collaboration with the Association of Nurses in AIDS Care (ANAC) and HealthHIV. The first three podcasts discuss how to:
- Help patients make the most of their health coverage
- Support continuous access to HIV medications
- Address patient affordability concerns
The Ask, Screen, Intervene course is designed for care providers of persons living with HIV and promotes the use of the clinical encounter for the prevention of HIV/STD transmission. This 3-part curriculum was originally developed to implement the Recommendations for Incorporating HIV Prevention into the Medical Care of Persons Living with HIV. The curriculum was updated in 2011 and 2013 to reflect current state of prevention efforts with persons living with HIV, in line with the National HIV/AIDS Strategy.
Partnership for Health (PfH) - Safer Sex: An Overview for Providers is a 30-minute course designed to help health care providers to recognize the benefits of integrating prevention messages into their clinic’s routine care for people living with HIV, utilize good communication skills to assess patients for HIV/STD transmission risk behaviors, and form “loss-frame” messages to deliver to patients who report transmission risk and/or non-disclosure of HIV status to sex partners. The primary target audience for this course is physicians who treat people living with HIV. In addition, anyone providing medical care or other support services to this population may find this information useful.
CDC's Prevention Research Synthesis (PRS) Project routinely updates an online Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention by adding newly identified evidence-based behavioral interventions (EBI) and best practices that have been scientifically proven to significantly reduce HIV risk or promote HIV care. CDC's Compendium now includes 84 HIV risk reduction (RR) evidence-based behavioral interventions, 10 HIV medication adherence (MA) evidence-based behavioral interventions, and 9 Best Practices for promoting linkage to and retention in HIV care (LRC).
Primary Care Development Corporation (PCDC) has developed a number of resources detailing best practice recommendations for how primary care providers can provide high quality care for their patients diagnosed with HIV. The full list of resources can be accessed through their website. A selection of available issues briefs is listed below:
- Building Routine HIV Testing into the Primary Care Visit
- How Primary Care Providers Can Help Patients With HIV
- One-A-Day HIV Treatments: How Do They Compare
The HealthHIV HIV Primary Care Training and Certificate ProgramTM is a free, online, self-paced, staged CME curriculum, based on a proven model of HIV primary care integration. Participants who complete the program, which is composed of five courses – HIV Management in Primary Care: Foundations Course; Core Skills for HIV Management in the Primary Care Setting; Assessment and Treatment Decisions in HIV/HCV Co-infection (UPDATE IN DEVELOPMENT); Considerations in the Management of HIV in Older Adults; and Improving Communication in the Clinical Setting – earn a certificate of proficiency in HIV primary care integration.
The HRSA/HAB-supported National Center for Innovation in HIV Care has released an issue brief on transgender women and PrEP. The brief includes a discussion of the research to date on the safety of PrEP use among transgender women, guidance for clinicians on prescribing PrEP to transgender women, and recommendations for more intensive research on HIV prevention technologies for transgender women. Learn more about the National Center for Innovation in HIV Care (this is not a US Government website).
The World Professional Association for Transgender Health promotes the highest standards of health care for individuals through the articulation of Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People. The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment.
The Center of Excellence for Transgender Health issued a Primary Care Protocol for Transgender Patient Care. The protocol provides accurate, peer-reviewed medical guidance, along with references to additional materials that may be accessed for further study and shared with other provider colleagues and support staff to improve treatment capabilities as well as access to care for transgender patients
The National LGBT Health Education Center provides educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, and transgender (LGBT) people. Available trainings and resources cover a broad array of health topics, including HIV, STIs, sexual health, and cultural competency. Resources of particular notice are listed below:
- Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers (in collaboration with the National Association of Community Health Centers)
- Affirmative Care for Transgender and Gender Non-Conforming People: Best Practices for Frontline Health Care Staff
On Demand Webinars
- Creating an Inclusive Environment for LGBT Patients and Staff at Your Health Center
- Taking a History of Sexual Health”: Opening the Door to Effective HIV and STI Prevention
- Anal Dysplasia and Cancer in At-Risk Groups: What Providers Need to Know
- Understanding Bisexuality: Challenging Stigma, Reducing Disparities, and Caring for Patients
- Collecting Data on Sexual Orientation and Gender Identity in the Electronic Health Record: Why and How
The Centers for Disease Control and Prevention developed the Every Dose Every Day e-Learning training toolkit for clinical and non-clinical HIV providers who serve persons living with HIV (PLWH). The toolkit features four evidence-based medication adherence strategies that can be delivered by a variety of HIV providers, including medical providers, licensed social workers, HIV case managers, health educators, and/or peers. The four strategies are:
HEART (CE# WB2257) - Individual/dyadic, social support and problem-solving intervention delivered before and in the first two months after initiating ART, includes a patient-identified support partner
SMART Couples (CE# WB2258) - Discordant couple-level intervention, addresses ART adherence and safer sex practices within the dyad, by fostering active support between partners
Peer Support (CE# WB2259) - Individual-and group-level intervention, where HIV-positive people, currently adherent to ART, serve as peers and provide medication-related social support
Partnership for Health for Medication Adherence (CE# WB2260) - Individual-level, clinic-based, brief provider-administered intervention emphasizes the importance of the patient-provider relationship to promote adherence
The resources also include the EVERY DOSE EVERY DAY (E2D2) mobile application (app) available for iOS and Android devices. The app builds on the Pager Messaging intervention by assisting people living with HIV with dose, refill, and medical appointment reminders. Additionally, the app features lab tracking (e.g., viral load and CD4 count) to help the user understand how their HIV treatment regimen supports better health. The mobile app can be used alone or in combination with any of the 4 medication adherence strategies.
PrEP – an HIV Prevention Option is featured on Start Talking. Stop HIV. This animated video presents basic information about PrEP and promotes communication between gay men and their healthcare providers about PrEP as a prevention option.
The Centers for Disease Control and Prevention PrEP Resources page provides infographics, videos, fact sheets, reports, and other educational materials about PrEP, including resources for health care providers.
Through the PrEPline, the National Clinicians Consultation Center (NCCC) at the University of California, San Francisco provides up-to-date clinical consultation for PrEP decision-making, from determining when PrEP is an appropriate part of a prevention program to understanding laboratory protocols and follow-up tests.
The Prevention Benefit of ART is an eLearning course provided by the Centers for Disease Control and Prevention through the Effective Interventions website. The course is designed to help clinicians to think about antiretroviral (ART) for people living with HIV as both effective treatment and effective prevention. This self-paced course is divided into four modules that will take approximately one hour to view. While the content of this course is relevant to anyone who works with these patients, physicians who complete the course can receive 1.25 units of free CME.
Prevention is Care: Incorporating Prevention into the Medical Care of Persons Living with HIV is a CDC campaign that provides tools for medical care providers to use on a daily basis with those patients who are living with HIV. The Prevention is Care resource toolkits include informational posters, patient education brochures, screening tools, relevant articles, media coverage, and testimonial videos.
Serostatus Matters is a video-based educational program designed to help healthcare providers incorporate routine HIV screening into clinical practice. Each of the 4 learning modules is approximately 18-20 minutes in length featuring real clinicians and is not scripted. The topics addressed include:
- The importance of routine HIV screening
- Practical considerations for HIV screening implementation in the primary care clinician’s practice
- Communicating test results with patients
- Counseling the HIV-infected patient
Doing It is a new national HIV testing and prevention campaign designed to motivate all adults to get tested for HIV and know their status. As part of the Act Against AIDS initiative, Doing It delivers the message that HIV testing should be a part of everyone’s regular health routine to keep ourselves and our community healthy. He’s doing it. She’s doing it. We’re doing it. YOU should be doing it, too.
Primary Care Development Corporation’s High Impact Prevention in Healthcare team developed the Opt-Out HIV Screening Strategies presentation to support practices in implementing an “opt out” approach to HIV testing. The Centers for Disease Control and the U.S. Prevention Service Task Force both recommend clinical practices utilize Opt-Out HIV testing strategies in order to increase the number of patients who consent to HIV testing and to bring more HIV+ patients into HIV medical care.
The April 2013 U.S. Preventive Services Task Force (USPSTF) Recommendations for Human Immunodeficiency Virus (HIV) Infection Screening state that clinicians should screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk should also be screened. The USPSTF recommends that clinicians screen all pregnant women for HIV, including those who present in labor who are untested and whose HIV status is unknown. Information about recommended screening intervals are included in the Clinical Considerations section of the recommendations.
The National Association of Community Health Centers’ Model to Integrate Routine HIV Screening Services in Federally Qualified Health Centers provides guidance to health centers on developing and implementing a process by which every patient 13 to 64 years of age is screened for HIV as a routine part of medical and dental care. This model is a step-by-step approach comprised of 8 steps designed to be carried out over a period of 90 days. The model was originally designed for use with rapid test kits. However, the current revision has been amended to allow for both rapid testing and lab testing.
The CDC has a number of resources on HIV Testing in Clinical Settings. Resources of particular relevance to the P4C project are listed below:
- Evaluation Toolkit: Patient and Provider Perspectives about Routine HIV Screening in Health Care Settings
- Implementation of Routing Testing in Health Care Settings: Issues for Community Health Centers
The HIV Screening. Standard Care. program developed by the Centers for Disease Control and Prevention (CDC) gives primary care providers new tools to help ensure all patients are tested for HIV at least once in their life, including a resource toolkit Program tools include a resource toolkit, with posters, patient brochures, and guides for clinicians. The program also supports the HIV Screening. Standard CareTM Resource Center which offers free medical and nursing education opportunities plus scientific articles for clinicians to learn evidenced-based approaches to incorporate HIV screening in their practice. A new segment of the campaign provides tools specific to improving HIV outcomes among African American and Hispanic/Latino patients by making HIV testing and linking to care the clinical standard.
Routine Rapid HIV Screening in Six Community Health Centers Serving Populations at Risk describes results from the analysis of the impact of application of CDC guidelines for routine screening in six health centers serving communities disproportionately affected by HIV in the southeastern US.