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The purpose of this paper is to gauge patients’ service perceptions of an interdisciplinary human immunodeficiency virus (HIV) clinic, which uses infectious disease physicians, medical residents, clinical pharmacists, nurses, social workers and students in HIV primary-care delivery.

Adult patients coming to the HIV clinic for a return visit to the interdisciplinary team completed a questionnaire based on a previously validated HIV-specific patient satisfaction study (n=104). Fourteen modified items assessing overall care-quality and ten original items assessing interdisciplinary services were included.

Respondents reported high satisfaction levels with the clinic's services. The mean score for the care-quality items was 3.79 (possible 4). The interdisciplinary care items mean score was 3.69 (possible 4). For non-physician disciplines, respondents indicated that nurses, pharmacists and social workers played important roles in their clinic care.

Bias associated with patient selection and survey methods limit the generalizability. The study has implications for measuring interdisciplinary care provided at HIV clinics.

This HIV outpatient care interdisciplinary model is not widely in use. Results are important for those involved in HIV service development and improvement. Findings support integrating non-physician providers into routine outpatient HIV medical visits.

At least 20% of individuals living with HIV pass through prison and jail doors every year, in any nation, worldwide. Therefore, interventions that improve access to HIV testing, HIV care, and education can have a broad impact on public health in every country. The benefits of these interventions in correctional settings have already been well documented. For example, improved access to HIV testing, treatment by an HIV specialist, preventive vaccinations and prophylactic medications, screening for concomitant infections such as HCV, and pre‐release planning services have been shown to decrease HIV‐related mortality and morbidity, to reduce the risk of HIV transmission and to decrease recidivism. Education of at‐risk individuals has also been shown to reduce HIV risk behaviors. Safe distribution of condoms and needle‐exchange programs have also been demonstrated to be safe and effective, although few such programs have been implemented in the United States. While all the available evidence has demonstrated that these public health‐oriented interventions can be and are successful in correctional settings, implementation on a national and international level lags far behind the evidence. The time has come to take an evidence‐based approach to improving HIV management in correctional settings. Implementations of the HIV management interventions described in this article make good medical sense and will have a positive impact on the health of inmates and the communities to which inmates return.

Chronic illnesses require long term, ongoing medical care as well as the provision of a variety of social support services. These diverse systems of care need to be integrated. However, under managed care, health care systems adhere to a disease model where emphasis is placed upon cure rather than care. While managed care can increase system coordination, the logic of cost containment favors acute services over the long term supportive services needed by chronic care clients. In this paper I describe efforts in one community which has received funding to integrate services for individuals with chronic mental illness as well as a planning grant to integrate multiple chronic care systems (HIV, mental health, and substance abuse) for minority clients. I describe various models of system integration and how diverse systems can be coordinated. In the conclusion I examine the barriers to system integration and argue that sociologists need to play a stronger role in understanding systems of care.