Meeting the Demand

With an increasing demand for HIV care and a decreasing number of doctors specializing in this area, HIV-positive patients could have difficulty finding a knowledgeable physician. But a new project called the HIV Workforce Capacity Building Initiative is trying to do something about that.

The initiative, an effort of the group HealthHIV (with funding from a Bristol-Myers Squibb Positive Charge grant), connects primary care physicians with HIV specialists who serve as mentors. The idea is for the two physicians to develop an ongoing relationship in which the mentor provides guidance regarding HIV care.

“What we’re finding is folks interested in expanding HIV knowledge are very busy, with a high volume of patients,” says Julio Fonseca, training and workforce manager for HealthHIV, which is based in Washington, D.C. The mentoring program allows them to expand that knowledge on a flexible schedule. After an initial face-to-face meeting with their mentor, they can then easily contact the mentor by phone, email, or videoconference when they have a question regarding treatment, how to talk to patients about HIV, or even how to overcome their own skittishness about discussing the issue.  

Primary care providers need HIV expertise more than ever, Fonseca points out. It’s estimated that when the Affordable Care Act is fully implemented in 2014, about a half million newly insured HIV-positive Americans will seek treatment, mainly in primary care settings, such as community health clinics. The fact that effective drugs have made HIV a chronic, manageable condition for many people in the U.S. means that HIV treatment needs to be part of a patient’s general health care. And most doctors specializing in HIV began practicing more than 20 years ago, and half are expected to retire in the next five to 10 years.
Since January 2012, HealthHIV has matched more than two dozen doctors with mentors, with each mentor taking on multiple relationships. Many of the primary care doctors being served so far are in urban settings, but there’s also a focus on getting mentors to providers in underserved rural areas, particularly in the South. In order to maximize the benefits, the project seeks to match mentors and primary care physicians by background and interest, Fonseca says.
“What really is key is the relationship that they have with their mentor,” he says.