What happens at HIV+ diagnosis where there's no link to a case manager?

October 7, 2016 11:04 AM

For a project at work, I'd like to know more about what happens at HIV+ diagnosis in settings where the patient isn't connected with a case manager (or peer navigator, linkage coordinator, or similar). E.g., at ER's, public health clinics, and any other diagnosis settings where connection to a case manager or similar isn't routine, what happens? Can you fill me in, or suggest how I can find out?

The kinds of details I'd like: who's involved, what's communicated and how, what are the steps, what happens later...?

My understanding is that patients who get case managers or similar are more likely to link to the medical care they need after diagnosis. I'm wondering about why and how some people end up without case managers, and what those diagnosis moments are like.

posted by daisyace to Health & Fitness (5 answers total)

I work on domestic HIV, but on a confidential and anonymous survey that includes HIV testing. Some of our surveys and testing are done at bars and clubs. We are not allowed to collect anyone's name or information, though we do give them back their HIV results.

We refer people to care, but cannot directly link them, since that would require we collect identifying information. In general, our participants need a confirmatory test as well. We give them information about where they can seek care, and give them an appointment. Depending on the state, we are required to report their results to the DOH, but a name or identifying information is not provided.
posted by quadrilaterals at 12:25 PM on October 7, 2016

Response by poster: Thanks, quadrilaterals. What kind of entity works in the way you describe -- is that outreach of an AIDS Service Org/Community-Based Org, or an academic institution's field project, or what?
posted by daisyace at 12:35 PM on October 7, 2016

Those who test positive for HIV by home HIV testing, available under the brand name Ora Quick, also may not come into contact with a case manager. There is a phone line for testers to access, but I am unsure of exactly how it works. A little poking around Google should reveal more about that protocol.

My understanding is that generally the alternative to having a trained individual (peer navigator, case manager, etc.) assist in obtaining services is simply providing the person who tested positive a name or list of places to get care. This is sometimes called "passive referral," and using that term in your searches may help you learn more.
posted by reren at 3:58 PM on October 7, 2016

I have worked in about 5 different emergency departments and we do not do HIV testing as a general rule because of the problems with follow up that you reference. We tell people they should go to a clinic or the DPH to have it done.

Some emergency departments do offer HIV testing but I'd venture to guess that the majority do not.
posted by treehorn+bunny at 4:53 PM on October 9, 2016

Response by poster: Thank you everyone, here and via memail. Much appreciated!
posted by daisyace at 4:04 PM on October 16, 2016