Date of Award
Master of Public Health (MPH)
Richard Rothenberg, MD, MPH
Natalie Crawford, Ph.D., MPH
Jane Kelly, MD
Introduction: Behavioral and medical interventions such as syringe exchange and anti-retroviral therapy have been successful in reducing the incidence and transmission of HIV and improving the longevity and quality of life of people with HIV/AIDS. However, there are an estimated 1.1 million people living with HIV in the United States and only about 37% are retained in some form of HIV care. People living with HIV often have multiple comorbidities and other challenges that often require specialty care.
Methods: We used data from the Medical Monitoring Project to assess HIV-related supportive service needs among people living with HIV in Georgia to understand whether there is an unmet need in this sample (n = 417). Descriptive tables and Chi-square tests were used to assess differences in types of HIV-related services needed and actually utilized by Blacks and Non-blacks. Bivariate and Multivariable logistic regression was performed to assess correlates of having at least one unmet need.
Results: The cross-section was a probability-based sample of people living with HIV/AIDS in Georgia. Blacks were more likely to need Preventative Education and Mental Health counseling than Non-blacks. Despite no significant difference in the need of ART Adherence Support between Blacks and Non-blacks, Blacks significantly had more unmet ART Adherence Support needs when compared to Non-blacks (p = 0.0097). Bivariate analysis showed those with a high school education and those who have experience homelessness were more likely to have unmet service needs (OR = 1.75 95% CI = 1.06 – 1.89) and (OR = 2.97 95% CI = 1.22 – 7.23) respectively. A multivariable logistic model correcting for potential confounding showed those who have experienced homelessness were more likely to have unmet service needs (OR = 2.49 95% CI = 1.02 – 6.11). The most cited reasons for not receiving a service need were Financial Barriers and Lack of Information.
Discussion: Marginalized groups exhibit greater need for supportive services and within these groups, a disparate proportion exhibit unmet needs compared to others. This analysis provides a programmatic framework to initiate better-focused efforts for sub-groups who exhibit more unmet needs.
Guffey, Taylor, "Analysis of Predictors of Unmet HIV-related Support Services and Barriers to Needs among HIV-infected Individuals in Georgia." Thesis, Georgia State University, 2015.