Research finds that patient navigation does not improve viral suppression rates among those with substance use disorders and HIV

New research funded by the National Institute on Drug Abuse (NIDA) found that intensive patient navigation support and financial incentives used to motivate patients with substance use disorders to engage in their HIV care, had no beneficial effect on their HIV viral suppression rate. Even though these incentives were designed to engage patients in antiretroviral therapy, there was no benefit to their rates compared with a standard treatment of linking hospitalized patients to outpatient care. The study results raise awareness about the need for health care professionals to have cost-effective and efficient strategies in providing care to patients with substance use disorders and HIV.

Participants with both HIV infections and substance use disorders were randomly assigned to receive six months of patient navigation (care coordination and case management), with and without a financial incentive, versus standard treatment. The HIV-1 plasma viral load of each patient was measured at the start of the study and again at six and 12 months. The authors found no differences in HIV viral suppression rates among the groups after 12 months.

Previous research has shown the potential for a combination of patient navigation strategies and the use of financial incentives in motivating patients to undergo substance use disorder treatment. This study was designed to assess the possible impact of a combination of these two strategies on improving HIV viral suppression rates.

The authors conclude that these findings demonstrate the critical need for developing effective approaches to improving health outcomes among substance use disorder patients with HIV, as this extremely vulnerable population has unique issues and comorbidities that require special interventions. The results underscore the importance of research in evaluating if multiple interventions are effective, and offer science-based guidance to health care professionals hoping to design cost-effective strategies that will offer optimal care.

For a copy of the abstract, “Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use,” published in JAMA, go to http://jama.jamanetwork.com/article.aspx?articleid=2533068#Abstract.

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