Research Projects

Project ARTAS

Project ARTAS ( Anti Retroviral Treatment Access Studies) was a four-year interdisciplinary project to assess and develop interventions to improve access to HIV related health care and antiretroviral therapy among disadvantaged populations in clinics in four metropolitan areas (Atlanta, Baltimore, Los Angeles, Miami) which refer a highly diverse population of HIV positive individuals to on-going medical and social services. The Study consisted of two components: 1) a randomized intervention trial and 2) an HIV Medical Care provider survey.

The intervention component examined the efficacy of a brief, intense case management intervention in improving the follow-through of recently diagnosed HIV-positive individuals to on-going medical and social services. The strengths-based case management intervention, ARTAS Case Management, consisted of five contacts designed to:

• Identify personal strengths and abilities that will encourage clients to follow-through with services
• Actively involve clients in identifying personal and system barriers to follow-through
• Advocate with service delivery entities on behalf of clients

To test the intervention, 316 participants were randomized to either the ARTAS intervention or a control group which received only standard HIV information and a referral to a local HIV medical care provider. Findings demonstrated the efficacy of the ARTAS approach.  There was a statistically significant difference between the proportion of ARTAS intervention participants who were linked to HIV primary care at the six-month follow-up, compared to control participants (78% of participants in the intervention arm were linked to care at 6-months follow-up compared to 60% of participants in the control arm). At the 12-month follow-up, this effect declines somewhat, but remains significant  (64% of the intervention group were linked to care compared with 49% of the control arm). These data are based on participants’ self-reports and confirmed with medical record data.  The study, its policies and procedures, were approved by institutional review boards at CDC and each of the four ARTAS sites.

The HIV Medical Care provider surveys documented the knowledge, attitudes and practices of physicians who provide care to HIV-infected patients. Phase I targeted HIV medical care providers of each of the metropolitan areas in which ARTAS Case Management interventions were conducted ( Los Angeles , CA ; Miami , FL ; Atlanta , GA ; and Baltimore , MD ). In Phase II, the Miami team surveyed providers from the three Southern Florida counties surrounding Miami-Dade County . Phase III targeted the remainder of the HIV medical care providers in the state of Florida and will allow, among other things, comparison of responses between rural and urban providers in the state. Emory University, one of the original ARTAS sites, has also been conducting an expansion of the ARTAS survey targeting rural providers in 4 states (Alabama, Georgia, North Carolina, and South Carolina) in the Southeastern United States. Once this data set is completed, we will examine responses between the rural HIV care providers in all five states.

Project ARTAS
Antiretroviral Treatment Access Studies

FUNDING SOURCE

Centers for Disease Control and Prevention
“ Intervention Epidemiologic Research Studies of HIV/AIDS – ARTAS Panel”

UNIVERSITY OF MIAMI (Investigators)

• Emory University School of Medicine
• Los Angeles County Department of Health Services
• Johns Hopkins School of Hygiene and Public Health

COMPLETED 2004