Creating an enabling environment to improve access and utilization of HIV/AIDS care in underserved communities: A case study from Chester, PA

Chester, PA is a minority-majority urban community in southeastern Pennsylvania with alarmingly high rates of socio-economic and health indicators namely: high poverty, homelessness, and unemployment rates, > 50% female headed households, > 75% population on Medicaid, highest infant mortality in the Sate, highest percentage of low-weight births in the Sate, second highest teenage pregnancy rates, high HIV/AIDs prevalence, and homicide rates in 15-44 males. AIDS Care Group, a community-based health care provider has been providing comprehensive health, dental care and referral care for the marginalized population in Chester for over a decade. Despite improved availability of services, access and utilization has traditionally remained very poor because of combination of conventional barriers – low health literacy, transportation, homelessness, insurance, unemployment, etc.

Capitalizing upon its decade long experience of community-oriented and participatory approach, ACG identified housing, transportation, food, clothing, cultural sensitivity and respect as key Client needs and adopted a model of care that adequately and appropriately catered to these identified client needs. ACG now has a cohort of 954 HIV/AIDS patients that has been in its care for at least 2 years or more. This cohort has seen improved prognosis, general and dental health outcomes under care. The presentation will discuss salient features of service delivery model, key support services that are associated with longevity and compliance in patients, and most importantly improved health outcomes attributable to it.