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Access to health care difficult for those with HIV

Institute of Medicine. HIV Screening and Access to Care: Health Care System Capacity for Increased HIV Testing and Provision of Care. Washington, D.C.: National Academies Press; March 17, 2011.

As the HIV health care work force grows closer to retirement age and fewer medical students enter this particular facet of infectious disease medicine, access to care may become more difficult, according to a recent Institute of Medicine report.

About half of the physicians listed in the HIV Medicine Association and about 60% of nurses listed in the Association of Nurses in AIDS Care are aged about 50 years. Fewer are entering this particular field, according to the report, but demands are growing. The government is pushing for increased HIV testing, and those with HIV live longer because of antiretroviral therapies.

Long-term coordinated care is expensive and requires clinicians from many different fields who may lack the proper training to properly care for patients with HIV, according to the report.

HIV patients are living to an age in which they are developing secondary medical conditions, such as cardiovascular diseases, cancer and dementia. This subpopulation of patients will require trained personnel.

Decreased funding is also likely to be a problem. During 2009, 29 states lost more than $170 million in funding for HIV programs, hindering maintenance of a proper work force. A lack of the appropriate number of qualified personnel could increase wait times for those who need the most access to care.

“The current and projected capacity of the health care work force to implement routine testing for HIV and to provide competent HIV/AIDS care to significantly increased numbers of patients is of grave concern,” the report said.

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