Case management was used first for people with AIDS in the early to mid-1980s (Aday et al., 1994; Mor, Fleishman, Piette, & Allen, 1993; Piette et al., 1990). In 1986, in response to the rapidly growing epidemic, the Robert Wood Johnson Foundation initiated the AIDS Health Services Program (AHSP) to develop local networks of human service agencies and to coordinate case management services (Mor et al., 1993). The program philosophy was that for AIDS case management to be successful, a central agency should coordinate all services received by an individual (Cruise & Liou, 1993). The program also was based on the "San Francisco model," which focused on providing community-based comprehensive care and was thought to be preferable to clients and more cost-effective.

Today, most AIDS case management is funded by the Ryan White CARE Act (administered by HRSA), which was signed into law in 1990 (Aday et al., 1994). The Ryan White CARE Act supports services to HIV-seropositive persons by directing communities to develop a comprehensive, coordinated system of health care delivery by building on resources in the community (Aday et al., 1994). HIV prevention is often mentioned as a general goal for Ryan White case management, but detailed descriptions of specific HIV prevention activities undertaken by AIDS case managers are seldom found in program descriptions. Furthermore, given AIDS case managers' usual heavy caseloads and other high-priority activities, HIV prevention is often only a minor part of Ryan White case management in many communities. This may change, however, as the need to provide ongoing support and assistance in the maintenance of safer sex and injection practices becomes clearer because of the new treatments that are extending health. 

Go to section 2.2.1 Practice