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Referral to Other Services

People with HIV often live with concurrent social and medical challenges.  Providers must assess other possible concerns, initiate appropriate referrals, and confirm follow-up.

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What is referral to other services?

Referral to other services is assessing a person’s needs for non-HIV medical and support services; providing information on and identifying resources to respond to the need; and facilitating the initial connection.  This process should begin immediately upon diagnosis of HIV infection.  The best referrals are designed to respond promptly to a patient’s assessed need and to confirm that the patient has been successfully linked to the referral resource.  (For information on CDC guidance and recommendations for referral to other services, refer to: http://www.cdc.gov/hiv/pwp/otherservices.html)

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Why do it?  What are the benefits?

  • Helps patients deal with concurrent medical and social challenges that affect their health outcomes and HIV transmission risks, such as the need for:

o Mental health and substance abuse treatment
o Non-HIV-related medical care
o Support for adherence to ART
o HIV risk reduction services and interventions
o STD services
o Partner services
o Assistance with legal services, housing or transitional living, transportation, nutritional counseling, child care services, employment, domestic violence intervention

  • Helps patients connect with other medical and support service providers in their community
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What are some of the barriers to referral to other services?

  • Unfamiliarity or discomfort with assessing patients’ needs that lie beyond the provider’s scope of responsibility
  • Unfamiliarity with local resources to respond to assessed needs
  • Lack of infrastructure to establish a referral network or time to make and monitor referrals
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What are some strategies to improve referral to other services?

  • Maintain updated referral networks
  • Collaborate and integrate services among providers
  • Establish well-defined referral policies and procedures and agreements among providers to follow these procedures
  • To determine patients’ needs, use assessment tools and protocols that are culturally appropriate and suited to patients’ language, gender, sexual orientation, age, and developmental level
  • Obtain patients’ consent prior to sharing patient information between agencies
  • Routinely evaluate the referral process to troubleshoot barriers and enhance facilitators affecting the process
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Who is involved to make it work?

Because the heart of the referral process is collaboration with other local providers to meet patients’ needs, anyone who provides services to people living with HIV has a role.  Successful referrals depend upon providers conducting accurate and culturally appropriate needs assessments and utilizing a comprehensive network of local service providers.

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Alberto's Story

I started drinking young. Then I dropped out of school so I could work at a garage.  A full-time job meant I had more money to party, and it wasn’t long before I was shooting up as well.  Once I went to this place to get sober, but it didn’t take long for me to go right back to using.  I lost a few jobs when I showed up late and hung over too many times, but my auto skills meant I could always get more work.  When I started...

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