Wednesday, October 23, 2013

Linkage to Care: Removing Barriers for Coloradans Living with HIV and AIDS

By Maria Chaidez and A'ra Blair

To help keep persons living with HIV and AIDS (PLWHA) in care, the Colorado Department of Public Health and Environment has two linkage to care (LTC) coordinators: Maria Chaidez and Ceasar Montoya.  They identify and reduce barriers to care, as required by the National HIV/AIDS Strategy, often focusing on individuals with low income or mental and behavioral health issues. They are guides, helping HIV-positives and their care providers get through the health-care system successfully while getting the financial assistance they need.


The CDC estimates that in the U.S. there are 1.1 million PLWHA. Only 37 percent of them are being actively treated or are, in other words, “retained in care”. And only 25 percent of them will reach viral suppression, meaning very low levels of HIV in the blood. Though Colorado’s numbers are slightly better than the national average, about 42 percent of PLWHA in Colorado are out of care.

This is because individuals newly diagnosed with HIV often fail to either start care or remain in it. But the amount of HIV in the blood—viral load— can be suppressed and maintained below detectable levels in a majority of infected persons who receive antiretroviral therapy. This dramatically improves the health of those that begin and stay in treatment.

Barriers keeping PLWHA from accessing care include financial difficulties, cultural or religious beliefs, substance abuse and mental health issues, and lack of transportation. But the two most cited reasons are personal choice—“I feel healthy, why should I go to the doctor?”—and poor health insurance.

LTC coordinators work with health care providers to help them navigate these barriers and keep patients in care. By watching out for signs of clients dropping out of care—like missed appointments—health providers and LTC coordinators work together to improve on-going access to care.

Whether individuals are trying to figure out their health care options or are looking for the money needed to cover costs, LTC coordinators working with community-based organizations, can help. As a result of LTC efforts by Colorado’s STI/HIV Section, in 2012, 94 candidates were identified for LTC services. Of these, 74 accepted services, a 79 percent success rate.

Through LTC efforts including timely intervention, problem solving, and support, drop-out rates for people living with HIV and Aids can be greatly reduced.

This is good news for Coloradans living with HIV/AIDS.

For more information regarding the Department’s HIV Linkage to Care services, contact Maria Chaidez at maria.chaidez@state.co.us . This blog will continue to provide up-to-date information on this topic. Thanks for reading!

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