SMAIF in Action: Health Models Program Removes Barriers to Successful HIV Treatment

Teresa* is a young African American woman living in the New Orleans area. She was only in her 20s when she found out that she is HIV-positive. Her journey toward viral suppression has had ups and downs. With her enrollment in the Health Models program, which was supported by the Secretary’s Minority AIDS Initiative Fund (SMAIF), Teresa finally was able to overcome barriers to successfully managing her HIV treatment and becoming virally suppressed. (Read our prior post about the Health Models program.)

After Teresa was diagnosed with HIV, she was linked to care at a clinic in New Orleans. Her first experience there was not a good one. Her experience of the initial clinic intake visit left her feeling horrible and she never wanted to return.  That one experience kept Teresa out of care for years.

Teresa was only able to start the HIV medical care that she should have received years ago when she was enrolled in the Health Models program. After years of not being in care, she was referred to Priority Health Care in a suburb of New Orleans, and decided to give treatment another chance after talking with them. She was enrolled in the Health Models program during her initial visit and the program changed her life.



The Health Models program helped Teresa overcome the negative feelings she had about going back into care. It also helped her deal with her diagnosis and the feeling that she was alone. She feared telling her family about her HIV status. Her live-in boyfriend was in denial and refused to be tested for HIV. Her negative feelings about her initial health care experience and having little support made it difficult for Teresa to manage her HIV medical care. Through the education she received from the Health Models Coordinator and medical case manager, Teresa finally understood the benefits of the HIV medical care she needed and felt comfortable enough to disclose her status to her family. The support of the Health Models Coordinator and her family were essential for her success.

In addition to barriers Teresa faced due to her diagnosis, she also had very practical barriers to receiving care. Teresa was concerned about taking time off work to attend HIV medical care appointments. She worked a minimum wage job that did not cover time off for medical appointments. So, she lost money every time she went to the doctor. One of the innovative strategies the Health Models program tested was the use of small incentives for attending appointments. The financial incentives she received through the program made it possible for her to take time off work to attend her HIV medical care appointments. To further improve her financial situation, the Health Models Coordinator also encouraged Teresa to follow her dreams, and she returned to school. Through the support and care she received from Health Models, Teresa achieved viral load suppression and maintained it for more than a year.

Teresa’s success was threatened by an unexpected tragic event. That trauma hit her hard, and she became depressed. Teresa felt hopeless about her life and whether her HIV status would prevent her from ever being in a relationship again or becoming a mother.  It was difficult for her to go to work every day, and she ultimately lost her job. All of this also affected her ability to take care of her health. She started having problems taking her medication every day, her viral load increased and was no longer suppressed.

Things would have been worse for Teresa if she had not participated in the Health Models program. Because the program and her family were there to support her, Teresa was able to get back into care, get back on track with her medication, and get the virus under control so that once again she reached viral suppression. In addition to her success at managing her medical care, Teresa also found a job in the field of social work.

Teresa’s journey illustrates a number of important lessons about starting HIV care and staying in it for life.

Viral suppression isn’t a short-term goal but a process with ups and downs. Health Models built a relationship with Teresa that took into account all of the barriers and challenges that made it difficult for her to get her HIV infection under control and to maintain a suppressed viral load. As Teresa’s experience shows, the types of support provided by the Health Models program may be needed at multiple points in time as people’s needs and the issues and challenges they face change over the course of a lifetime.

Teresa’s experience is just one of many positive stories out of the SMAIF-funded Health Models program. Take a look at HIV.gov/smaif for more information about the Health Models program.

SMAIF improves HIV prevention, care, and treatment for racial and ethnic minorities through innovation, systems change, and strategic partnerships and collaboration. SMAIF supports 33 projects in 40 states, D.C., Puerto Rico, and Guam that are conducted by 200+ health departments, health centers, and community organizations. For more information on SMAIF visit HIV.gov/smaif.

*The name of the client was changed to protect her privacy.