Outpatient/ambulatory medical care (OAMC) includes the provision of professional diagnostic and therapeutic services rendered by a physician, physician‘s assistant, clinical nurse specialist, nurse practitioner, or other health care professional who is certified in his or her jurisdiction to prescribe antiretroviral (ARV) therapy in an outpatient setting. These settings include clinics, medical offices, and mobile vans where clients generally do not stay overnight. Emergency room services are not considered outpatient settings.
Services include diagnostic testing, early intervention and risk assessment, preventive care and screening, practitioner examination, medical history taking, diagnosis and treatment of common physical and mental conditions, prescribing and managing medication therapy, education and counseling on health issues, well-baby care, continuing care and management of chronic conditions, and referral to and provision of specialty care (includes all medical subspecialties). Primary medical care for the treatment of HIV infection includes the provision of care that is consistent with the PHS‘s guidelines. Such care must include access to ARV and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination ARV therapies.
Early Intervention Services provided by Ryan White Parts C and D programs are reported under outpatient/ambulatory medical care.
Best Practices and Emerging Models
- Partnerships for Care (P4C): Health Departments and Health Centers Collaborating to Improve HIV Health OutcomesHRSA Bureau of Primary Health Care (BPHC), Centers for Disease Control and Prevention (CDC)Toolkit to help Health Centers expand the provision of HIV services.
- The HIV, Housing & Employment ProjectCOVID-19 adjustments developed by Ryan White HIV/AIDS Program recipients.
These resources synthesize findings from the federally funded SPNS Hepatitis C Treatment Expansion Initiative, which focused on HCV treatment among coinfected patients.
- HRSA HIV/AIDS Bureau (HAB)Highlights from projects that offer highly effective (and replicable) approaches to integrating buprenorphine-based medication-assisted treatment into HIV/AIDS primary care.
- AETC National Coordinating Resource Center (NCRC)
HIV clinical training resources for HRSA's AIDS Education and Training Centers Program.
- National Clinician Consultation Center
Healthcare providers can receive no-cost expert clinical consultation in HIV prevention & care, HCV treatment, and substance use management.
- University of Washington
Online clinician training platform with evidence-based core competency training on HIV prevention, screening, diagnosis, care, and key populations.
- U.S. Department of Health and Human Services
U.S. HIV-related treatment guidelines, drug database, and glossary.
- SPNS Sexually Transmitted Infections InitiativeTools to help clinics improve screening, testing, and treatment of common bacterial STIs among people with HIV or at risk for HIV.
- National Council for Behavioral Health
Resources on integrating primary care with behavioral health services to better address mental health and substance use needs.
Roadmap on steps to take in setting up depression screening in a program.
- Cleveland/Lorain/Elyria TGA
Tools developed by a Part A program to monitor programs and services.
- New York State Department of Health AIDS Institute
HIV-specific, validated tool to assess patient satisfaction with HIV primary care.
Frequently asked questions about buprenorphine care; chapter in the Integration of Buprenorphine into HIV Primary Care document.
Webinars and Training
- HRSA HIV/AIDS Bureau (HAB)
Pre-application webinars for Notice of Funding Opportunity (NOFO) announcements from HRSA's HIV/AIDS Bureau for the Ryan White HIV/AIDS Program (RWHAP).
- Center for Engaging Black MSM across the Care Continuum
Web training site to educate providers on the delivery of HIV health care services for black men who have sex with men to enhance engagement/retention in care.
- Technical Assistance Provider Innovation Network (TAP-in)Recordings of the TAP-in webinars on topics critical to the Ending the HIV Epidemic Initiative.
- Integration of Buprenorphine into HIV Primary Care Settings: Tools from the Integrating HIV Innovative Practices ProgramHRSA HIV/AIDS Bureau (HAB)
Resources to assist Ryan White HIV/AIDS Program and other HIV clinics to integrate buprenorphine programs within primary care settings.