The Program for HIV-infected Case Management and Behavior Changes of the Cases
Biing-Tzong Chi, An-Chi Liu, Yen-Fang Huang, Chin-Hui Yang
2010 Vol.26 NO.16
Correspondence Author： Biing-Tzong Chi
The Program for HIV-infected Case Management was started in 2007 in Taiwan, providing HIV-infected case management through medical institutes to increase efficacy of medical care and to establish better self-health management techniques. Medical institutes are encouraged to take the responsibility of caring and educating HIV-infected patients. A support network consisting of social affair authorities and the medical systems is also established through the program to support minority groups. The program gradually increases the rate of seeking medical care and practicing safe behavior of HIV-infected cases to prevent transmission of HIV.
Since the plan was started in 2007, a total of 4,672 cases were enrolled at the end of 2008. Among them, 1,402 were new cases reported by case management hospitals in 2007-2008. When compared to follow-up of new cases at outpatient departments, managed cases had higher compliance rates than unmanaged ones, showing that the plan helps in medical compliance.
Through comparison of the record of case management and our database, we found that most cases were started to be managed within one month after being reported (1,003, 21.5%). However, only about 30% of the new cases were managed. Hence, through increasing the numbers of case management hospitals and encouraging them to cover new cases, the number of new cases being managed would increase. The plan would alleviate the psychological impact of HIV infection, establish regular hospital visits and to provide better self-health management techniques earlier to prevent drug resistance and transmission of HIV.
Through regular heath education and consultation, we found significant reduction in sexual and drug addiction behaviors of the cases after we first received the cases, as compared with the follow-up results in the most recent three months. The rate of having a fixed sexual partner rose from 61.1% to 76.6% in sexually active cases. The rate that patients informed their sexual partner also increased from 53.1% to 65.6%. Upon behaviors of drug addiction, the rates for using clean injection devices and alternative therapies also increased. As for medical treatment, the rate of regular medical visits increased from 60.9% to 87.6%, and the rate of regular taking of the medication also increased from 31.5% to 51.0%.