261805 A Needs Assessment for HIV-Positive Clients Receiving Ryan White-funded services

Monday, October 29, 2012 : 12:30 PM - 12:45 PM

Rhodri Dierst-Davies, MPH , Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Amy Wohl, MPH, PhD , Division on HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA
Glenda Pinney, MPH, JD , Los Angeles County Commission on HIV, Los Angeles, CA
Background: HRSA, the primary funder of HIV care for low-income persons in the US, requires each jurisdiction receiving Ryan White(RW) funding to justify need, set priorities and conduct resource allocation using evidence-based data. Methods were developed to identify a representative sample of the 18,545 HIV+ RW clients in Los Angeles County(LAC) for purposes of a needs assessment. Methods: A cross-sectional, two-stage, proportional-to-size sampling design was used to identify a statistically representative sample of facilities(n=46) and participants(n=450) from January-April 2010. Facilities were stratified by type(e.g.,medical, housing/transportation, substance abuse, social services) to ensure proportional representation. Real-time sampling was used to identify and recruit participants. Data were collected on demographics, service awareness, needs, services received, satisfaction with services, needed services that were not received(e.g., gaps) and barriers. Logistic regression analysis was used to examine factors associated with gaps. The facility and participant response rate were 100% and 94% respectively. Results: Awareness of services was high(99%) and all reported a need for at least one service. The majority of participants reported at least one service gap(81%) and homelessness was associated with the presence of a service gap(OR=3.7;95%CI:1.1-12.4). Among Latinos, low income was associated with a service gap(OR=3.0;95%CI:1.4-6.7). The largest individual service gap was for dental services(34%) and incarceration(OR=2.7;95%CI:1.2-6.1), lack of health insurance(OR=1.8;95%CI:1.2-2.9) and substance use(OR=1.8;95%CI:1.1-2.8) were associated with this gap. Common barriers were individual (e.g.,not knowing where to go/who to call). Conclusion: Methods were developed to obtain a representative sample of client data that can reliably be used for priority setting and resource allocation.

Learning Areas:

Learning Objectives:
1. Design a needs assessment for Ryan White-funded services 2. Describe the service needs and service gaps of Ryan White recipients in Los Angeles County

Keywords: Ryan White, Needs Assessment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a public health professional for several years and have worked on studies involving HIV in-care patient populations. I have also worked on several publication and given professional presentations related to population based HIV surveillance research.
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.

Back to: 3238.0: Barriers to HIV/AIDS Care 2