A continuation of the AIDS Policy Research Center (APRC), which provides timely research and evaluation data to inform policies and programs that respond to the HIV epidemic in the state of California. The ARPC is a collaboration of the University of California, San Francisco (UCSF), one of the leading HIV research centers in the world, and the San Francisco AIDS Foundation (SFAF), one of the oldest AIDS service organizations in the United States. In addition, SFAF partners with Project Inform, one of the leading sources for HIV treatment information and advocacy. Over the course of the next four years, we will conduct both rapid response research and longer-term projects related to HIV policy in the state of California.

Our rapid response research will be conducted through a Rapid Response Core. We will seek to (1) identify important HIV-related policy issues affecting California; (2) conduct innovative policy analysis and research on selected issues; and (3) distribute our findings to policymaking, clinical, community, and academic audiences. Our work will be aided by advice and input from a Policy Research Advisory Committee (PRAC), consisting of diverse individuals with knowledge of HIV policies at the local, state, and federal levels.

The research proposed for our longer-term studies will help to ensure that people living with HIV in California are able to receive high quality care and services. We specifically propose two projects. (1) First, we will complete an evaluation of five Patient-Centered Medical Homes (PCMH) demonstration projects in HIV care settings. The PCMH helps create a more integrated, coordinated care environment that better serves patients with complex health conditions. We have developed a comprehensive research design. Our methods include qualitative interviews, surveys, and observations of demonstration site personnel, clinical providers, and patients. (2) Second, we will examine the effects of health reform on patient access to HIV primary care. The major provisions of the Patient Protection and Affordable Care Act are due to take effect in January, 2014, midway through the upcoming grant cycle. At that time, coverage for many people will change from one payer source to another, and this may lead to different rules for receiving treatment and services, new provider networks, and new coverage levels. During this time, HIV patients may experience disruptions in care. We propose to conduct clinic surveys and patient and provider interviews before and after health reform changes in 2014 to understand experiences getting care while health reform is taking place and to estimate the percent of patients whose access to care is disrupted.