One-Stop Shop HIV/AIDS Programs
Since retention in care, adherence to treatment, and disease self-management are all essential parts of HIV prevention, many rural programs use a one-stop shop approach – providing both prevention and treatment services simultaneously.
One-stop shop HIV/AIDS programs provide:
- Prevention and education services
- Treatment services
- Psychosocial support
- Case management
- Additional services to assist people with finances, food, housing, and transportation needs
Rural community-based organizations implementing HIV prevention and treatment activities in rural communities offer many of these services – using a one-stop shop approach – to provide a comprehensive support system for clients.
In response to the HIV outbreak in rural Indiana in 2015, local state officials developed a one-stop shop program model to help reduce the transmission of HIV. The Indiana model was comprehensive, including HIV testing, routine vaccination services, care coordination, improved access to health insurance and healthcare, substance use disorder treatment referrals, and transportation assistance for accessing healthcare services.
One-stop shop programs assist people living with HIV/AIDS with the entire spectrum of care, often including services for non-health-related issues and other barriers to care in order to address the needs of their specific populations.
Examples of Rural One-Stop Shop HIV/AIDS Programs:
- Health Services Center (HSC) is a community-based, nonprofit organization and medical clinic that provides healthcare services, education, and support to people living with HIV/AIDS and their families in rural communities of eastern Alabama. Case managers at HSC meet with clients prior to receiving medical care and provide support with HIV treatment, as well as ancillary support such as assistance with paying utility bills, gaining access to necessary HIV medications, and filling out applications for disability insurance. HSC is a Ryan White recipient and also provides mental health services, substance use disorder treatment programs, and prevention education for people living in their service area.
- The mission of Chattanooga CARES (CARES) is to “reach, assist, and support people impacted by HIV, Hepatitis C, and STIs.” The organization achieves this mission by providing a comprehensive range of services to clients, including HIV testing, direct healthcare in their Chattanooga Primary Care Center (CPCC), case management, a food and nutrition program, support groups, transportation, and housing assistance. CARES is a Ryan White Clinic and Center of Excellence for HIV, providing both primary and specialty health services. In addition, CARES implements several Centers for Disease Control and Prevention Evidence-Based Interventions and Best Practices for HIV Prevention within Chattanooga and surrounding rural counties.
- Rural AIDS Action Network (RAAN) offers a range of services and programs to both prevent transmission and assist in treating existing cases of HIV for rural communities in Minnesota. The case management program provides education on compliance with treatment instructions, care coordination for treatment, and referrals to mental health and substance use disorder care. Along with this, RAAN also offers free HIV/hepatitis C testing, nutrition assistance programs, support groups, benefits counseling, a syringe exchange program, and assistance with transportation needs.
- Southern Tier AIDS Program provides comprehensive HIV/AIDS services, including a main focus on prevention. Some of the specific services offered through this program include a syringe exchange program, opioid overdose prevention program, a women's services program, M4 Project (men who have sex with men from communities of color), substance use information and referral services, and a criminal justice initiative.
- Matthew 25 AIDS Services “exists to provide individuals with high-quality services, support, and treatment of HIV/AIDS infection.” The organization targets people residing in communities in western Kentucky and southern Indiana. Matthew 25 provides holistic, patient-centered services including treatment by an HIV specialist, disease education by a trained retention nurse, consultation with a mental health counselor, and a final meeting with a staff member who discusses barriers with HIV disease management. Along with these services, Matthew 25 also provides housing assistance and information about nearby food pantries and offers various local financial assistance services.
- Open Aid Alliance is an organization that “hopes to prevent HIV, hepatitis C and sexually transmitted infections through testing, education, and outreach in western Montana.” Open Aid Alliance offers free HIV and hepatitis C testing, case management, HIV education in the local community, free counseling services, housing assistance, and a syringe exchange program. Community medical services are also available twice a month.
- Ursuline Sisters HIV/AIDS Ministry is a faith-based organization in Ohio that works with adults and children impacted by HIV/AIDS. They provide comprehensive health and social support services at three different locations in the Mahoning Valley region. Ursuline Sisters provides support groups; pastoral visits to homes, hospitals, and prisons; patient advocacy and support; housing support; a food and household item pantry; and a comprehensive clinical care center. In addition, the organization has trained peer navigators who serve as patient advocates and provide support throughout the treatment process. These peer navigators provide translation services and transportation for people who live far from the Comprehensive Care Center. The peer navigators are also certified to conduct HIV testing. They travel all over the region to health departments, correctional facilities, substance abuse facilities, college campuses, health fairs, local stores, and other locations to conduct testing.
Considerations for Implementation
One-stop shop programs provide many services for people living with HIV/AIDS under one roof and can be effective in reducing barriers to retention and adherence. In order to provide comprehensive services and meet diverse needs, it is essential to build a strong network for the program within the local community. In particular, local healthcare and social services organizations can provide valuable client referrals.
Since there is a stigma associated with HIV/AIDS in many communities throughout the U.S., organizations will need to carefully select a location to set up a one-stop shop program – one that will be welcoming to the people who are using the programs and services. Community buy-in is very important to the success of these programs.
Since this program model integrates different types of services for people who are living with HIV/AIDS, organizations should promote the importance of teamwork, consider specific staff competencies, and facilitate training. Cultural and linguistic considerations should always be taken into account; programs will need to make sure that services and materials are accessible and understandable. When determining an appropriate name for the organization, some programs have used a non-descript name that does not directly reference HIV.
Resources to Learn More
Essential Components of Effective HIV Care: A
Policy Paper of the HIV Medicine Association of the Infectious Diseases Society of America and the Ryan
White Medical Providers Coalition
Describes necessary components of a HIV care model that, along with reforms in government healthcare policies, can improve outcomes for those living with HIV and prevent new infections. A key component of this model is coordinated care between primary, specialty, psychosocial, and social service care providers. Other important components include access to HIV experts, quality improvement measures, integration of electronic health records, and financial sustainability of the model.
Author(s): Gallant, J.E., Adimora, A.A., Carmichael, J.K., et al.
Citation: Clinical Infectious Diseases, 53(11), 1043-1050
The One Stop Shop: An Integrated
Model of Early Intervention Services in HIV Care
Describes a one-stop shop model of care implemented within the Caguas, Puerto Rico service area which spans both a rural and urban region. Includes a discussion of how the Gurabo Community Health Center was able to integrate different types of care in one place and provides several important considerations for other programs looking to implement a similar model.
Author: Figueroa, D.
Organization(s): Gurabo Community Health Center, Inc.