Information Center Bulletin
Volume 3, No. 2

Demonstration Programs Offer Hope for People with HIV/AIDS

Health care providers often find it challenging to help individuals with HIV (the virus that causes AIDS) adhere to a complicated treatment regimen. Yet, simple as it may sound, offering mental health services and assertive case management can be the key to compliance.

Health care providers in San Juan, Puerto Rico, have developed an innovative program that combines integrated services and specialized case management. The program is greatly improving the quality of life for people with HIV/AIDS.

“Specialized case management is the center of the wheel of the integrated services system,” says Francisco Javier Parga, M.A., coordinator of the Psychology and Case Management Section for the Office for AIDS Affairs and Transmittable Diseases, Puerto Rico Department of Public Health. “It keeps everything balanced. Without specialized case management, the whole system wobbles.” Parga headed the Center for Mental Health Services’ (CMHS) Positive Care: Mental Health Services for People with HIV/AIDS Program in San Juan, Puerto Rico.

The San Juan program was one of 11 uniquely tailored services demonstration sites throughout the country funded by CMHS. The program strove to maximize its one-stop shopping capability. For example, in addition to primary medical care, neurological evaluation and treatment were provided on-site, as part of the demonstration program, rather than referring a client to another agency or clinic.

“People who are affected by HIV/AIDS may experience adjustment disorders, depression, or mood disorders as a complication of the disease,” Parga says. “They also may need a variety of supports to help them cope with the isolation or stigma associated with HIV. And they often have other problems, such as addiction to illegal drugs, that can prevent them from adhering to a treatment regimen.”

In order to help people affected by HIV/AIDS who abuse drugs, case managers must be plugged into community resources. Community supports can range from a 12-step recovery program to child care for a woman strapped for cash who fears her children will be taken away if she enters a drug rehabilitation program. “Supports such as these may seem simplistic,” Parga says, “but they can make the difference between someone who stops using illegal drugs and enjoys an improved quality of life to someone who becomes another statistic by falling through the cracks of the service system.” Mental health services for persons living with HIV/AIDS have to include practical interventions that facilitate access to a variety of resources needed to help manage the diverse complications of the disease. This is particularly true when the consumer faces other life situations, such as drug use, that interfere with the ability recovery.

The Puerto Rico site, in collaboration with the ten other sites, developed a practical guide for replicating the most effective interventions in other communities. Entitled Mental Health Care for People Living With or Affected by HIV/AIDS: A Practical Guide, this “how-to” manual includes major lessons learned throughout the course of the 4-year HIV/AIDS Mental Health Services Demonstration Program. It also describes kinds of services needed, models of care that can deliver these services most effectively, and the benefits of collaborative networks. For more information about the guide, visit the Information Center web site at mentalhealth.samhsa.gov/cmhs/HIVAIDS/default.asp.

To learn more about the HIV/AIDS Mental Health Services Demonstration Program and other CMHS HIV/AIDS programs, visit the Information Center's home page at mentalhealth.samhsa.gov. For more information about the Puerto Rico program, contact Francisco Javier Parga, at 787-274-5601.

Information Center Bulletin
Volume 3, No. 2