Penn researchers study to improve HIV patient treatment experience

Researchers from Penn Medicine are working to improve the health of HIV patients in Philadelphia through research.

According to a new study led by Baligh Yehia, assistant professor of medicine and attending physician at Philadelphia Veterans Administration Medical Center, HIV-positive patients who visit more than one clinic in a calendar year see less success in treatment than those who consistently see one provider.

The study was written along with Kathleen Brady, an infectious disease physician at Pennsylvania Hospital and senior author, as well as Robert Gross and Ian Frank, who are the director and co-director of the Penn Center for AIDS Research’s Clinical Core.

The study sampled data from 2008, 2009 and 2010. The team discovered that about 1,000 of the 13,000 patients they studied had visited multiple clinics in a year and, as a result, saw little improvement in their health.

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According to Yehia, patients who are not consistent in which clinics they visit are less likely to repress the virus or receive proper treatment. When patients are not responding correctly to their treatment, they become more susceptible to side effects such as depression and are more likely to transmit the disease.

The team used data from the City of Philadelphia Department of Public Health and studied clinic attendance, antiretroviral therapy use and suppression of the HIV virus during the three-year period. According to their study, those who visited multiple clinics were less likely to use antiretroviral therapy and saw little suppression of the virus.

These patients are more likely to be young, black, female, on public insurance or without insurance and receiving their first year of treatment, according to the study.

The study began in March 2013 and was published this month. Yehia said he started the study based on his “own experience treating HIV patients who came from different providers” and the issues that came with this trend.

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For Yehia, the next step is to do qualitative studies on what actually makes patients choose to go to several clinics rather than one. “Our hope is that we can sit down face-to-face with patients and discuss why this is,” Yehia said.

Gross and Yehia have already started working on a plan to improve retention in HIV care at clinics in response to the results of their study. The pair will soon begin studies on the population of veterans who are HIV-positive in Philadelphia.

“We will hopefully then be able to spread our intervention plan to the surrounding community,” Gross said.

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Ronald Collman, co-director of Penn CFAR, is passionate about advocacy for projects such as Yehia’s and said a large focus of his organization is to provide services and support, even in areas outside of HIV/AIDS research. Collman said he has been in conversation with the University about creating a supportive atmosphere around initiatives like Yehia’s Penn program for LGBT health — a separate endeavor about health education.

“Baligh is a rising star amongst our HIV researchers,” Collman said.

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