Results from a study published in AIDS Care support the efficacy of interprofessional collaboration in linking patients with HIV to care services. Specifically, psychosocial providers such as social workers, health educators, and outreach workers who collaborated with other clinicians provided more linkages to HIV testing and primary care than those who did not.
Investigators abstracted baseline, 12-, and 24-month follow-up data from a 5-year longitudinal study. Providers from 36 agencies in New York City completed a 150-question survey that assessed HIV-related training, linkages to HIV testing services and primary care, experiences with interprofessional collaboration, and job satisfaction. Providers were asked how many patients they had linked to HIV testing services or primary care facilities. Logistic regression analyses were performed to identify the factors associated with greater service linkages.
A total of 245 providers contributed data at all 3 time points. All providers were members of nonprofit agencies, and the mean (standard deviation) age was 42 (12) years. Most providers were women (64%), black or African American (54%), and not Hispanic or Latinx (65%). The majority (65%) held a bachelor’s degree or higher. The most commonly reported title was case manager (24%) or counselor (21%). At baseline, 75.9% of providers reported involvement in some form of service linkage.
Higher interprofessional collaboration was associated with greater odds of linking patients to HIV testing (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.00-2.39). Providers with HIV training (OR, 1.81; 95% CI, 1.07-3.09) and providers who were younger (OR, 0.98; 95% CI, 0.95-1.00) and Hispanic/Latinx (OR, 1.96; 95% CI, 1.06-3.64) also had significantly higher odds of linking patients to HIV testing. Providers who received HIV training more than 2 years before survey participating made more HIV testing linkages than providers without training (OR, 2.64; 95% CI, 1.12-6.23). Higher interprofessional collaboration was also associated with high odds of primary care linkage (OR, 1.58; 95% CI, 1.03-2.42). Providers who had received HIV training more than 2 years before the survey (OR, 2.45; 95% CI, 1.07-5.62), Hispanic/Latinx providers (OR, 2.37; 95% CI, 1.30-4.34), and younger providers (OR, 0.97; 95% CI, 0.95-1.00) also had higher odds of linking patients to HIV primary care.
Limitations of the study include the fact that provider data were self-reported and the fact that researchers queried providers about behaviors that occurred in the last 6 months, which may have led to recall bias.
These data highlight the importance of interprofessional collaboration in improving the flow of patients through the HIV care continuum. Provider training initiatives and education programs may improve care linkage frequency, which may in turn lead to greater numbers of patients receiving HIV testing and primary care. As patient-level data were not obtained, however, investigators could not ascertain the precise effect of care linkages on patient outcomes. Additional research is necessary to identify patient-level gaps in the HIV care continuum.
Pinto RM, Kay ES, Choi CJ, Wall MM. Interprofessional collaboration improves linkages to primary care: a longitudinal analysis [published online September 17, 2019]. AIDS Care. doi:10.1080/09540121.2019.1668537