Date of Award

1-1-2010

Document Type

Campus Access Dissertation

Department

College of Nursing

Sub-Department

Nursing Practice

First Advisor

Stephanie Burgess

Abstract

HIV infection is a significant problem in the United States, with Southern states being disproportionately affected by the epidemic. Three federal programs, the Ryan White Treatment Program, Medicare, and Medicaid, provide funding for the majority of HIV-infected persons in specialty clinics but often cannot be applied to primary care. South Carolina has increased rates of HIV among females, minority races, and residents of rural areas, rendering them especially dependent upon federal funding to finance their HIV care.

Currently, most HIV patients are treated at dedicated HIV clinics by infectious disease specialists. Problems with HIV care include lack of access to primary healthcare providers, social stigma, accessing HIV care, and poor coordination of generalized primary care of their other health conditions. Over the last ten years, advances in medications and clinical management of HIV have transformed the disease into a chronic condition. A new model of care could improve care and patient outcomes, especially the lack of access to healthcare among minorities and rural residents.

The Chronic Care Model (CCM), already used to coordinate care for chronic conditions such as diabetes and heart failure, can be readily applied to HIV care. The CCM can be used by nurse practitioners to incorporate HIV care into primary care. Transition of HIV care to primary care providers such as nurse practitioners will require professional development to increase relevant knowledge of HIV treatment and clear HIV treatment guidelines for primary care providers.

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