Falling Through the Cracks

Abstract

Despite growing numbers of people living with HIV (PLWH), the landscape of related services is shrinking. This study investigated health and social service needs of men (N = 489) and women (N = 165) living with HIV in Atlanta, GA. Participants completed confidential measures asking about the health and social services they needed and accessed. Results showed an array of health and social service needs among PLWH; failure to access services was prevalent. Hunger was among the most common basic needs, reported by greater than 60% of men and women. For men, unmet service needs were associated with fewer years since testing positive for HIV, higher CD4+ T cell values, experiencing more stressors and depression, and greater quantity of alcohol use. For women, failure to access services was associated with experiencing depression and not receiving HIV medications. Providing basic services to PLWH remains a public health priority and moral imperative. Keywordsaccess to services; HIV services; service needs © 2011 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The author(s) report(s) no real or perceived vested interests that relate to this article (including relationships with pharmaceutical companies, biomedical device manufacturers, grantors, or other entities whose products or services are related to topics covered in this manuscript) that could be construed as a conflict of interest. In addition to increased detection of new HIV infections, the growing number of people living with HIV (PLWH) is a product of improved HIV treatments. The trajectory of HIV disease has changed from a life threatening illness to a chronic condition (El-Sadr et al., 2010;Kumarasamy et al., 2010). Combination antiretroviral therapies (ART) for HIV infection have added years of longevity and improved the health of those infected with HIV. Deaths from AIDS have declined annually since 1996 when effective treatments first became available (HIV-CAUSAL Collaboration, 2010;Mugavero et al., 2007). Improvements in the prophylaxis and treatment of opportunistic illnesses are also responsible for more PLWH leading productive lives. The growing population of PLWH is, however, placing pressure on HIV-related health and social services. NIH Public AccessJuxtaposed to the growing population of PLWH are shrinking HIV-related services. One study of service utilization by more than 2,100 consumers of HIV prevention and care programs in California showed a wide-range of services accessed, with some individuals receiving multi...

Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States

“…56 Food insufficiency and housing concerns have also been reported by many PLH. 60 PLH with less stable housing report more depressive symptoms and lower QOL. 51,61,62 Additionally, food insecurity is associated with poor mental health among PLH.…”

“…In a review of studies addressing barriers to care for rural PLH, transportation needs and lack of financial resources were 2 of the most commonly discussed barriers 56 . Food insufficiency and housing concerns have also been reported by many PLH 60 . PLH with less stable housing report more depressive symptoms and lower QOL 51,61,62 .…”

Comparison of geographic methods to assess travel patterns of persons diagnosed with HIV in Philadelphia: How close is close enough?

“…Pattern analyses have been used to compare subgroups within a larger cohort [11][12][13][14], and have proven capable of delineating geographically precise points of targeted intervention [1,11,15,16,9,17]. Proximity analyses have been used to identify underserved communities, and identified utilization trends that do not always conform to resource planning assumptions [11,[18][19][20][21].…”

Client-Identified needs and agency-provided services at a harm reduction community based organization in the District of Columbia

“…Vulnerable populations utilizing community-based organizations (CBO) for service provision often have multiple basic needs that are unmet. These needs -- which include stable housing, food assistance, and medical care -- have been well documented in homeless or marginally housed [ 1 , 2 ], substance using [ 3 , 4 ], mentally ill [ 5 ], and HIV positive populations [ 6 , 7 ]. Addressing these needs may lead to improved mental and physical health outcomes (e.g., stabilization of mental health and chronic health disorders) for individuals and decreased financial burden to the community (e.g., through primary care and emergency room visits) [ 8 , 9 ].…”