Falling Through the Cracks: Unmet Health Service Needs Among People Living With HIV in Atlanta, Georgia

University of Connecticut, Storrs, Connecticut, USA.
The Journal of the Association of Nurses in AIDS Care: JANAC (Impact Factor: 1.23). 04/2011; 23(3):244-54. DOI: 10.1016/j.jana.2011.01.005
Source: PubMed

ABSTRACT Despite growing numbers of people living with HIV (PLWH), the landscape of related services is shrinking. This study investigated health and social service needs of men (N = 489) and women (N = 165) living with HIV in Atlanta, GA. Participants completed confidential measures asking about the health and social services they needed and accessed. Results showed an array of health and social service needs among PLWH; failure to access services was prevalent. Hunger was among the most common basic needs, reported by greater than 60% of men and women. For men, unmet service needs were associated with fewer years since testing positive for HIV, higher CD4+ T cell values, experiencing more stressors and depression, and greater quantity of alcohol use. For women, failure to access services was associated with experiencing depression and not receiving HIV medications. Providing basic services to PLWH remains a public health priority and a moral imperative.

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    ABSTRACT: Background Harm reduction case management relies on client-identified goals to drive the provision of care in order to “meet clients where they are at”. This research measured the level of agreement between client-identified needs and agency-provided services at a community based organization (CBO) in Washington DC by examining: (1) the services clients most often identified, (2) the services most often given to clients by the CBO, and (3) the level of alignment between client-identified needs and services provided. Methods Case file reviews were completed for 151 clients who received case management services at the CBO between January 2010 and February 2011. Client-identified needs and agency-provided services were extracted from case files and divided into 9 matching need and service categories: pharmaceutical assistance (e.g., prescription renewal), medical or dental care, housing, mental health services, substance use services, support services (e.g., support group meetings), legal assistance, and employment/job training. Client-identified needs and services provided were analyzed using McNemar’s Chi-square to assess for significant differences in discordant pairs. Results Clients were mostly Black (90.7 %), heterosexual (63.6 %), HIV positive (93.4 %), and over 40 years old at the time of intake (76.2 %). On average, clients identified 2.44 needs and received 3.29 services. The most common client-identified needs were housing (63.7 %), support services (34.3 %), and medical/dental care (29.5 %). The most common agency-provided services were housing (58.2 %), support services (51.4 %), and medical/dental care (45.2 %). In 6 of the 9 service categories, there were statistically significant (p < .01) differences between those who received services not asked for and those who did not receive asked for services in the categories of pharmaceutical assistance, medical/dental care, substance abuse services, support services, legal assistance, and food access. In each of these matched service categories, the percentage of clients who received services not asked for was significantly higher than those who did not. Conclusion This research shows that, while there is general alignment between the services that clients most often want and the services most often provided, there are still instances where services are requested but are not being provided.
    Harm Reduction Journal 06/2015; 12(1). DOI:10.1186/s12954-015-0051-4 · 1.26 Impact Factor


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