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November 2007

Ryan White Title II Consumer Needs Assessment Southwest/Piedmont HIV Care Consortium HIV/STD Resources. November 2007. Living with HIV or AIDS - 2007. 22 million people worldwide 18,814 people in Virginia 1,430 people in the Southwest Region of Virginia. HIV consumer needs assessment.

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November 2007

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  1. Ryan White Title IIConsumer Needs AssessmentSouthwest/Piedmont HIV Care ConsortiumHIV/STD Resources November 2007

  2. Living with HIV or AIDS - 2007 • 22 million people worldwide • 18,814 people in Virginia • 1,430 people in the Southwest Region of Virginia

  3. HIV consumer needs assessment • Provides the Southwest/Piedmont HIV Care Consortium with a management tool to maximize the effectiveness and efficiency of HIV services • Satisfies the requirement that the Southwest/Piedmont HIV Care Consortium, a Part B Consortium, carry out an assessment of needs as outlined in the Ryan White HIV/AIDS Treatment Modernization Act of 2006

  4. Purpose of the assessment • To identify issues and concerns of individuals living with HIV/AIDS in Health Region III of Virginia • Information is used by the Consortium to ensure effective and efficient planning, for implementation and evaluation of HIV health and social services in Southwest Virginia

  5. Methodology • In October 2007 - six hundred seventy four(674) consumer surveys were distributed to 7 Ryan White Title II subcontractors in Southwest Virginia • Surveys were then distributed via case managers to clients between October 1 and October 31, 2007. • The four-page survey contained both closed and open-ended questions. • Self-addressed envelopes were provided for clients who chose to return the survey individually. • A total of two hundred seventeen (217) clients returned the consumer survey for a response rate of 32% of Ryan White clients.

  6. Section I Demographics of Survey Respondents

  7. 1 13 1 Male Female Male to Female 74 Transgendered Female to Male 127 Transgendered Missing in System Mostly males • GENDER • Male 58.8% [127] • Female 34.3% [74] • Trans.Male to Female .5% [1] • Trans. Female to Male .5% [1]

  8. More People in the 40-49 Age Range Participate in Ryan White Survey 90 80 70 60 50 Number 40 30 20 10 0 0-19 20-29 30-39 40-49 50-59 60+ Majority between ages of 40-49

  9. Race African American 4 2 Caucasian/White 1 Asian 87 Pacific/Islander 112 Native American/Alaskan Other Mostly Caucasian

  10. Educational Attainment 80 60 40 20 0 Less than 12th Grade High School Some College Undergraduate Degree Postgraduate Degree 51 51 64 29 11 Number 48.1% report college experience

  11. Employment Other 5 Retired 9 On disability 102 8 Unemployed waiting on disability Unemployed looking for work 15 17 Part time Full time 49 0 20 40 60 80 100 120 47.2% on disability

  12. Total Household Income 5 Less than $10,000 7 $10,001- 28 $20,000 $20001 to 96 $30,000 $30,001- 59 $50,000 $50,000 and above 44.4% have incomes of $10,000 or less

  13. None Medicaid 45 49 Medicare 1 9 Medicaidand Medicare 34 Medicare and 57 Supplemental Veteran’s Benefits 54 Private Insurance 22.7% have no health insurance

  14. Section 2 Primary HIV Positive and AIDS Information

  15. 63.4% report having sex with men

  16. Men having sex with men

  17. AIDS Diagnosed by Doctor 8 89 Yes No Don't Know 110 41.2% were diagnosed by doctors

  18. Have Had Symptoms of HIV 140 125 120 100 80 71 60 40 17 20 0 Don't Know Yes No 57.9% experience symptoms of HIV

  19. Section 3 HIV Positive/AIDS Services Information

  20. Length of Time to Start Receiving Services After Testing Positive 120 104 100 80 60 54 44 40 20 9 0 Within a month 1-6 months More than 6 months More than 1 year 74.9% receive care within 6 months

  21. What Would have Helped to get Services Sooner Nothing- I got help right away 18.0 Knowing how important 32 early care was Not having to take care 11 of family or others Knowing who to 141 call/where to go 25 Not using drugs or alcohol 9 Not being so Afraid 38 Other Importance of early care/being afraid

  22. Currently Receiving RW Services 180 160 140 120 100 80 60 40 20 0 Don't Know Yes No Ryan White reaches 78.7% with services

  23. In the Last Year, How Often have You Seen Your Doctor about HIV? 9 29 53 Never 1-2 times 3-4 times More than 4 times 120 55.6% visit doctor 3 or more times yearly

  24. Transportation interferes with visits

  25. Emergency Room Visits Because of HIV/AIDS 12 27 None 1-2 More than 2 176 Emergency room visits are few

  26. Physical Health Compared to a Year Ago 100 94 90 82 80 70 60 50 40 37 30 20 10 0 Same Better Worse 81.5% feel the same or better

  27. Section 4 Knowledge and Information about HIV+/AIDS

  28. Easy to Talk with Doctors about HIV Treatment 13 Yes No 202 92.1% say it’s easy to talk with doctors

  29. Doctor Explains Things Clearly 250 207 200 150 100 50 6 0 Yes No 79.2% say doctors explain things clearly

  30. Informed about Missed Doses of HIV Drugs 250 197 200 150 100 50 17 0 Yes No 89.8% know consequence of missed drugs

  31. Your doctor/nurse Who Gave You the Most Information About HIV+/AIDS practitioner Nurse/Other healthcare worker 20 Case manager/Social 13 worker 11 Friends 18 18 Support groups 170 Newspaper/Books 38 Internet 47 Other Doctors/Practitioners information source

  32. Doctor has Discussed HIV Prevention 13 Yes No 199 Doctors Give HIV+ Information

  33. Currently Enrolled in RW Services 180 160 140 120 100 80 60 40 20 0 Yes No Don't Know 77.8% enrolled in Ryan White

  34. Doctor visits/lab services top list Number of People Reporting Priority of Services Offered

  35. Services needed - not offered Number of People Reporting Priority of Services Not Offered

  36. Section 5 Consumer Needs

  37. Health Care Needs and Unmet Needs Enroll in Hospice Care Stay in a Nursing Home Children’s HIV care Other rehabilitative therapy Home health care Physical therapy Home med. and health supplies Need Advice on nutrition/healthy eating Unmet Need See a Mental Health Counselor Get Help with Insurance Premium Help paying for medications Eye care Dental care See a Doctor or a Specialist Laboratory tests related to HIV 0 50 100 150 200 Health care unmet needs

  38. Support Services Needs and Unmet Needs Get Childcare Help with translations/interpreting Grief counseling Help taking my HIV Drugs Get education/non-medical HIV Serv Spiritual counseling/support An advocate (peer, lawyer) Needs UnmetNeeds Get Transportation to Medical Apts Legal assistance or advice Support groups Education about HIV Treatments Get Food Case management 0 20 40 60 80 100 120 Support services need/unmet need

  39. Employment training/counseling Domestic Violence Services Pet care Household helpers Volunteer companion (buddy) Clothing Financial Counseling Needs Information about Alternative Meds Unmet Needs Short Term Housing Assistance Help with Private Insurance Emergency payments for housing Get Emergency Food Help applying for Food Stamps Assistance with paying Utilities 0 20 40 60 80 Other services needs/unmet needs

  40. Barriers to Care Sexual Identity Discrimination Lack of childcare Language barrier Racial discrimination Gender Discrimination Sexual Orientation Discrimination Long wait to be seen at the clinic Long waiting list Confidentiality issue(s) with service provider Transportation to services Cost of medications/services Too much income to qualify Fear of disclosing HIV+ status Services unavailable Do Not Know where to go for services 0 10 20 30 40 50 60 Barriers to care

  41. Summary Overall, the 2007 Ryan White Client Needs Survey indicates that clients are pleased with the services they are provided and that these services result in more needs being met than not. Areas of need that consistently show are financial in nature and may be a reflection of the relatively low levels of annual income reported by the respondents. Finally, more attention needs to be given to removing the barrier of “Not knowing where to go for services.”

  42. Ryan White Program In 1991 the Council of Community Services became lead agent for the Southwest/Piedmont HIV Care Consortium (S/PHCC) in central, Southside and Southwest Virginia. This coalition of agencies and individuals has provided HIV medical care and support services through local subcontractor sites in Covington, Danville, Floyd, Giles, Lynchburg, Marion, Christiansburg, Pulaski, Roanoke and Radford

  43. HIV Resource and Training Center • Robert (Rob) Morrow is the Director of the HIV Resource and Training Center. He is a leading authority on HIV and AIDS in the Commonwealth of Virginia and across the United States. For more information regarding the Ryan White Program, the Southwest/Piedmont HIV Care Consortium or the Virginia HIV/AIDS Resource and Consultation Center, contact robertm@councilofcommunityservices.org

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