Community-Based HIV Care Models in Chicago

Segment Description: At IDWeek 2019, Contagion® sat down with Max Brito, MD, MPH, professor of medicine at the University of Illinois, to discuss his poster presentation on comparing HIV treatment in a community-based model versus a hospital-based model.

Interview transcript: (modified slightly for readability)

Contagion®: What were the differences between the 2 care models in your study?

The main difference between the 2 care models in the study is that these are community clinics. So we take HIV care to the community and 5 five clinics throughout the city of Chicago, and the main hospital-based clinic. So what we basically did was to compare the virologic outcomes of patients treated at those clinics, to the patients treated in the hospital. The patients at the clinics were more likely to be uninsured, underrepresented minorities, they were more likely to be homeless, or be lost to care for more than a year.

So despite having all these adversities, [we found that] the care was similar. And I think that has to do with the outreach team that we have that gets these patients wherever they are to try to get them care. And we call it the indigenous leader outreach model. They're basically people from the community who serve as peers. They bring the patients to care and they follow up on them and stuff like that. So that kind of intensive outreach, I think is what makes this model successful.

Contagion®: What type of outreach was included in this study?

We partnered with the Community Outreach Intervention Project at the University of Illinois with a model called the indigenous leader outreach model. The model was pioneered by [the university] to target and to bring to care IV drug users. And we co-locate our neighborhood clinics with this project.

They provide HIV testing, clean needles for persons who inject drugs, etc. And then that provides for easy linkage to care of our patients if they're turned HIV positive or hepatitis C positive. But they also serve another function, which is they are recruiters. They go find the patients wherever they are, so even if we have, for example, homeless patients, our outreach workers where we have these clinics, they know where they these patients are, and they can go get them and bring into care, they can get medications to them. They provide bus passes, meal vouchers if they need to. So we think that intensive street outreach makes a difference when you're dealing with bringing into care hard to reach populations, like the ones we deal with, in inner-city Chicago.