Monitoring and improving the quality of health care facilities involved in the continuum of care on HIV, STI and viral hepatitis

Abstract

When considering the treatment for HIV infection, maintaining high rates of undetectable viral load is decisive not only in the individual's clinical outcomes, but also in a wider transmission prevention perspective. A sustained HIV viral suppression may depend on the patient's adherence to antiretroviral therapy, which is impacted by the quality of care provided by the health care facility. The quality of care is important for all the health conditions. However, HIV quality of care faces more challenges. On one side the AIDS stigma and discrimination. In the other side, the wide variety of health care facilities ranging from small primary care centers for large hospitals. There is thus the need of having evaluation, monitoring (M&E) and improving quality of care (QI) programs, which have to be valid and applicable to different health care facilities.Since 1998, the Qualiaids research team has been developing, under my coordination, research and intervention projects in quality of care of HIV care facilities. Currently, we have two finalizing projects: 1) evaluating HIV facilities across Brazil; 2) improving quality and integration among HIV, STI and Hepatitis C care facilities in Sao Paulo state. The New York State Department of Health AIDS Institute has demonstrated certain long-established tradition in projects on improving quality of care provided to persons living with HIV, HCV, STIs, and related comorbidities.Despite presenting many important differences in health care systems, Brazil and the U.S. share some quite relevant similarities regarding to HIV care. Both countries experience an epidemic that is concentrated in specific social groups, and both have a very diverse range of facilities providing care and treatment to HIV patients. By carrying out this project, which is a 6-month study program at the New York State Department of Health AIDS Institute, I aim:a.To improve the analysis of the data collected as part of my projects previously mentioned b.To obtain new methodological approaches with regard to the quality improvement for projects on M&E and QI for HIV and Viral Hepatitis Cc.To establish scientific cooperation and students interchange projects between my Faculty and the AIDS Institute and others academic institutions at New York State. (AU)