Innovation in Meeting HIV-positive Patient Needs across the Spectrum of Care: A System-Level approach to service integration and workforce capacity building in San Diego, California

San Ysidro Health Center (SYHC) is a Federally-qualified Health Center that provides comprehensive primary care services and family support programs to over 85,000 registered patients residing in the South and Southeastern Regions of San Diego County annually. Their proposed SPNS Project is in direct alignment with the health center’s mission by aiming to increase access to and utilization of comprehensive primary care services among the HIV-positive patient population via successful integration of HIV care in the community clinic setting.

SYHC’s project has two overarching goals. The first is to provide a seamless continuity of a full spectrum of care for persons living with HIV. This includes establishing a team-based care model that will promote improved communication between HIV and non-HIV providers to support continuity of patient care including full-spectrum service utilization and improved patient health outcomes. It also includes the implementation of a service integration model that uses a systems-based approach to foster optimized communication between HIV and non-HIV providers to support continuity of patient care including full-spectrum service utilization.

The second goal is to develop a sustainable clinical workforce pipeline that secures medical resident capacity to serve HIV-positive patients in primary care settings. This will be accomplished by establishing a residency rotation that will systematically engage family medicine residents into primary care environments to develop their capacity and self-efficacy to deliver primary care to people living with HIV/AIDS.