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December Spotlight: HIV/AIDS Research in VA

Human immunodeficiency virus (HIV)—the chronic, progressive disease that leads to Acquired Immune Deficiency Syndrome (AIDS)—was first identified 30 years ago, and since then, more than 25 million people have died of AIDS worldwide. In the United States, the Department of Veterans Affairs (VA) is the single largest provider of healthcare for HIV/AIDS, caring for approximately 23,463 HIV-infected Veterans.

Investigators with VA's Health Services Research & Development Service (VA HSR&D) conduct studies aimed at identifying and treating HIV—particularly via the HIV/Hepatitis Quality Enhancement Research Initiative (QUERI), whose highest priority is to identify, understand, and minimize deficiencies in the care of HIV-infected Veterans. In recognition of World AIDS Day on December 1, VA HSR&D offers these research highlights, along with additional resources for Veterans and their family members affected by HIV/AIDS.

Recent VA HSR&D Studies

• Veterans in Favor of Internet-Provided HIV Screening Information
  This study, published in the August 2011 issue of BMC Research Notes, examined patient and provider perceptions of Internet-based outreach to increase HIV screening among Veterans who use the VA healthcare system. Study results showed that both Veterans and providers thought that HIV screening outreach provided electronically via VA's personal health record (MyHealtheVet) would improve patient access to health information, with important educational value. Providers believed that it would reinforce messages they give to their patients. Veterans could envision instances in which information provided electronically might be better than verbal information from their doctor because it would be in lay language and readily available. Veterans also believed that electronic outreach would motivate them to be proactive about their health.
• Rapid HIV Testing in VA Emergency Departments Financially Equivalent to Usual Care
  This study appeared in the January 2011 issue of the Journal of Emergency Medicine, and examined the budget impact of implementing a routine oral HIV rapid-testing program in a VA emergency department. Findings show that a routine oral HIV screening program using a rapid testing approach was financially equivalent to following a usual care approach within the VA healthcare system. While the HIV rapid-testing program increased screening costs, those costs were offset by lower inpatient expenses associated with earlier identification of disease.
• Collaborative Care Intervention Improves Depression in Veterans with HIV
  Depression is one of the most common mental health disorders afflicting individuals with HIV. Published in the January 2011 issue of Archives of Internal Medicine, this study examined an evidence-based model for collaborative care of depression in primary care and adapted it to an HIV clinic setting. Study results showed that the collaborative care model was successfully implemented in HIV clinic settings, and that using this model showed improved depression and HIV symptom outcomes.