Public policy on providing services for people living with HIV and AIDS (PLWH/A) has focused on identifying and meeting need through medical, social, and counseling services while reducing barriers to access and receipt of those services. Unfortunately measurements of need are often confounded with service utilization and quality or standards of care. Objective need is based on pre-established standards, usually set by providers or clinical researchers. Perceived needs are what consumers say will lead them to seek care. Unmet need is the resulting incongruence between the perspectives of the client and the provider. This differs from the current definition that need is the gap between what is and what should be the health status. Services for PLWH/A originally focused on preserving a minimum level of social/financial stability for individuals whose health status was difficult to maintain. When more sensitive diagnostic tests could detect HIV within days of the infection and dramatically improved drug therapies (HAART) established higher standards of care, the provider's perception of required services expanded. Infected individuals may still take years to perceive medical needs, but may very quickly identify and seek services for social and counseling needs related to daily living. This suggests that the place of need in the traditional medical access utilization models, using morbidity alone, is incomplete. Our model retains predisposing and enabling factors but divides needs into medical and supportive needs. While directly related to morbidity, medical and supportive needs mediate between morbidity and the utilization of medical and supportive services respectively.
Learning Objectives: At the conclusion of the session, the participants will be able to: 1. list different ways in which needs and unmet needs are defined and measured. 2. recognize the impact of improved testing and treatments on needs of people living with HIV/AIDS 3. apply the new model to their own needs assessments and research efforts
Keywords: HIV/AIDS, Needs Assessment
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.