Background
In the wake of medical treatment advances for HIV/AIDS, non-medical ancillary services have been pressed to achieve two objectives: (1) addressing specific human service needs and (2) assisting individuals in accessing and maintaining primary HIV medical care. This study explores the impact of ancillary services on entry and retention in to medical care in New York City.
Methods
Using data from the CHAIN Study, a five-year longitudinal study of 952 HIV-positive adults, we conducted a series of multivariate analyses using event history methodology. Our analysis was built on matching specific ancillary services to corresponding needs, given our hypothesis that ancillary services exert their greatest effect on individuals with a need for that service. Four medical care outcome measures were used – (1) entry into primary HIV medical care from a state of no medical care, (2) entry into HIV medical care that meets certain minimum preferred practice guidelines, (3) continuity of care at the same medical provider agency over consecutive 6-month interviews, and (4) continuity of primary medical care that meets the minimum practice guidelines, regardless of whether the care was delivered at the same medical provider agency.
Results
Ancillary services demonstrated a significantly positive effect on increasing the odds of individuals entering medical care and retaining appropriate medical care. The services displaying the greatest impact included therapeutic drug treatment, coordinative case management, mental health services, and housing services. Services matched to specific needs often displayed a significantly greater positive effect than services received by individuals without specific needs.
Learning Objectives: At the conclusion of this presentation participants will be able to consider the impact of comprehensive health system design on increasing access and retention to primary HIV medical care. Participants will also learn several strategies for measuring primary care continuity and retention
Keywords: HIV/AIDS, Primary Care
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.