Publications

Evaluating Patient-Centered Medical Homes (PCMH) for HIV Care

UCSF investigators are evaluating the effectiveness of Patient- Centered Medical Home (PCMH) demonstration projects, which were recently funded through a initiative from the California HIV/AIDS Research Program (CHRP). This work is part of the APRC’s commitment to studying the effectiveness of innovative models of care recommended by the CHRP-sponsored Visioning Change Initiative. The new PCMHs are community-based care systems that aim to provide coordinated, high quality, client-centered services for persons with HIV/AIDS. Interest in the PCMH model is driven by the changing nature of the HIV epidemic and the United States healthcare system. HIV increasingly affects underserved and older populations...

Understanding the implementation of Pre-Exposure Prophylaxis (PrEP) to prevent HIV in California

Scientists announced the results of the iPrex trial in November 2010, showing that overall, a daily dose of Truvada, a combination of two oral antiretroviral drugs, tenofovir disoproxil fumarate and emtricitabine, reduced HIV infection in a sample of high-risk men who have sex with men (MSM) and transgender (TG) women by 44 percent. Among those study participants who took Truvada 90 percent of the time, the effect increased to a 73 percent reduction in new infections. While these findings are significant, and have implications for the HIV prevention arena, it is unclear how the trial results will be understood and...

Costs and Benefits of Enhanced HIV Surveillance in California

Ryan White Comprehensive AIDS Resources Emergency (CARE) Act (RWCA) funding is provided to states to cover HIV medical care, treatment, and ancillary services for under-and un-insured persons with HIV and AIDS. California began names-based reporting of HIV (non-AIDS) cases in 2006, thus it is likely that some HIV cases are reported in the code-based registry and not in the names-based registry. It would be cost-beneficial to California to expand HIV surveillance efforts to add persons already in care to the HIV names-based Registry. It is estimated that each additional case registered would add $1675-$1707 to Ryan White allocations, but cost...

Assessing California’s Response to Federal Health Care Reform

California has amended a number of laws to be compliant with health care reform. Implication: Even if federal law were repealed or ruled unconstitutional, a number of regulatory rules from health care reform would remain in effect in California.

Examining the Impact of the HIV-related State Budget Cuts

During the summer of 2009, the State of California experienced an unprecedented budget crisis, resulting in cuts to social services across the state. Approximately $85 million was eliminated from the budget of the State Office of AIDS (OA) for FY 2009-2010, about half of the allocation of $167 million in FY 2008-2009. Following the cuts, reports in the local media and press releases indicated that several community-based organizations (CBOs) and AIDS service organizations (ASOs) had to close their doors or drastically reduce the level of HIV-related services, including activities such as HIV testing and counseling. The UCSF AIDS Policy Center...

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