Advancing Patient Navigation for HIV: Evaluating Models of Care for Housing and Employment.
Joseph S LightnerSteven ChesnutHoward J CabralJanet J MyersRonald A BrooksThomas ByrneSerena RajabiunPublished in: AIDS and behavior (2024)
People with HIV face challenges securing housing and employment. Patient navigation is an effective intervention that can improve the receipt of these services, which have been linked to better health outcomes. The purpose of this study was to assess implementation of patient navigation in diverse delivery settings. We also evaluated the relationship between these services and health outcomes among participants. Twelve sites in the United States (N = 1,082) implemented navigation using single or multiple navigator interventions to improve housing, employment, viral suppression, and retention in care. Sites included health departments, health centers, and AIDS service organizations (ASO). Client-level data were used to model relationships of interest. Across the 12 sites, regardless of model, housing (odds ratio (OR) = 1.18, p < .001), employment (OR = 1.09, p < .001) and retention in care (OR 1.11, p = .007) improved significantly over time; however, viral suppression did not (OR = 1.04, p = .120). Regardless of model of care, patient navigation improved housing, employment, and retention in care. This study demonstrated that while navigation supports people with HIV in securing housing and employment, models using a more intensive format worked best in specific settings. While most studies focus on unimodal strategies, this study builds on the evidence by examining how navigation models can be delivered to reduce barriers to care.
Keyphrases
- healthcare
- mental illness
- mental health
- palliative care
- quality improvement
- antiretroviral therapy
- public health
- affordable care act
- case report
- hiv infected
- human immunodeficiency virus
- hiv positive
- primary care
- hepatitis c virus
- pain management
- hiv aids
- sars cov
- health information
- machine learning
- electronic health record
- men who have sex with men
- climate change