Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

John J. Chin, PhD, Michael Botsko, MSW, Elana Behar, MA, Anthony Lewis, BBA, and Ruth Finkelstein, ScD. Division of Health Policy, New York Academy of Medicine, 1216 5th Avenue, New York, NY 10029, 212-419-3537, jchin@nyam.org

Background: The impact of HIV-related social services on physical health can seem unimportant when compared to the impact of HIV medical care. There are clearer relationships between social services and “intermediate” outcomes (entering stable housing, reducing substance use, initiating HIV medications), results that social services are designed to achieve. Attaining intermediate outcomes may have a direct relationship with health-related quality-of-life (QOL), an important indicator of how clients feel from their own perspective. Methods: The sample consists of 1813 HIV-positive clients from 23 agencies funded through the Minority AIDS Initiative. Demographics, housing stability, antiretroviral medication (ART) status, substance use, biological markers and QOL (using the ACTG QOL 601-602 Health Survey) were measured at program entry and quarterly thereafter. Analysis of Covariance modeling was used to assess changes from baseline QOL at 3 and 6 months controlling for intermediate outcome attainment and baseline characteristics. Results: Positive intermediate outcome attainment was significant: 23% of clients unstably housed at baseline achieved stability at first follow-up; 40% of active substance users stopped using substances; and 35% of clients not on ART started ART. Intermediate outcome attainment was significantly associated with changes in QOL at both 3 and 6 months. For example, clients who stopped using drugs, went on ART or found stable housing experienced respective increases of 9.2, 10.6 and 6.1 in their QOL measure of “general health” at 3 months. Conclusion: HIV social service programs are important in facilitating clients' attainment of intermediate outcomes, which have significant impact on clients' quality of life.

Learning Objectives:

• 1. Articulate the reasons that intermediate outcomes (e.g., attaining stable housing, reducing or ceasing substance use) are more appropriate measures of the effectiveness of HIV social service programs than biological measures (e.g., CD4 count, viral load).
• 2. Recognize the importance of health-related quality-of-life measures for evaluating the impact of HIV social services.
• 3. Describe the relationship between the attainment of intermediate outcomes and improvements in health-related quality-of-life.

Keywords: HIV/AIDS, Quality of Life

Presenting author's disclosure statement:

Not Answered