228612 What are the Disparities in Service Needs among a Representative Sample of HIV Positive Patients in Los Angeles County

Monday, November 8, 2010

Rhodri Dierst-Davies, MPH , HIV Epidemiology Program, Los Angeles County Department of Public Health, Los Angeles, CA
Judith Tejero, MPH , HIV Epidemiology Program, Los Angeles County Department of Public Health, Los Angeles, CA
Amy R. Wohl, PhD , HIV Epidemiology Program, Los Angeles County Department of Public Health, Los Angeles, CA
Background: Psychosocial support services can improve HIV outcomes and disease management through adherence to medications and retention in regular primary care among HIV patients. More information is needed to understand socio-demographic differences in types of support services needed and receipt of services for programmatic purposes.

Methods: A representative sample of HIV-infected adults who received care in Los Angeles County in 2007-2008 (N=330) completed an interview that included assessment of service needs and receipt of services. Odds ratios(OR) and t-tests were calculated to examine characteristics associated with reported needs.

Results: The most frequently reported needs were assistance in finding dental care, HIV case management, and mental health services. Factors associated with needing dental services includes completion of the interview in Spanish (OR=2.3(1.4-3.8)), Latino race/ethnicity (OR=2.5(1.5-4.3)), African American race/ethnicity (OR=2.1(1.1-4.3)), and lower education (OR=2.5(1.4-4.2)). Factors associated with needing HIV case management included African American race/ethnicity (OR=4.7(2.3-9.5)), homelessness (OR=3.1(1.4-7.2)), and receipt of public assistance (OR=2.8(1.7-4.7)). Although many clients reported having their needs met, the most reported unmet needs were shelter services and dental services. Homelessness (OR=2.56(1.11-5.94)) was associated with having multiple unmet needs. Need for multiple services was associated with having at least one unmet need.

Conclusions/Implications: Factors associated with needing services were those related to underserved populations (minority status, non-English language, lower education). Unmet needs were associated with homelessness and multiple service needs.

Learning Areas:
Chronic disease management and prevention
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
By the end of the session, participants will be able to identify disparities associated with HIV+ patients in LAC who are more likely to need access to expanded medical and psychosocial care.

Keywords: HIV/AIDS, Social Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am employed by LAC DPH as an epidemiology analyst and assisted in the data collection and analysis
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.