Background: Recent advances in medical therapies have changed the character of the HIV epidemic. Consequently, the service needs of people living with HIV have also changed. These changes present an opportunity to study EMA's responsiveness in incorporating these changes into HIV/AIDS health services systems. Methods: Using a cluster case study design, we analyzed primary and secondary data sources for six EMAs, including Portland, Kansas City, Chicago, Philadelphia, San Francisco and New Orleans. Primary data included interviews with the grantee, Title I planning council members, and other key HIV/AIDS service providers. Secondary data sources included HRSA applications, expenditure data, needs assessments and comprehensive plans. Results: In general, Title I planning councils were able to respond effectively to advances in treatments and have found unique ways of addressing disparities in access to care. EMAs with well-developed primary care delivery systems responded most effectively. Despite existing planning and needs assessment processes, some planning councils responded slowly to treatment changes. Conclusions: There is little evidence that advances in treatment had any effect on the functioning of the planning councils, but did have a tremendous effect on priority-setting and resource allocations. Our findings suggest that community involvement in planning services and allocating funds results in more accountability in service delivery and contracting, as well as the design of service systems that reflect local populations and needs.
Learning Objectives: By the end of this session, the participant will be able to: 1. Describe how planning councils address disparities in access to treatments 2. Describe how service use has changed due to treatment advances 3. Discuss how planning councils can more effectively reduce barriers to care and treatment
Keywords: HIV/AIDS, Ryan White
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.