Testing a service integration model: Results from the HIV/AIDS initiative, ConnectHIV

Abstract

Staff of 20 AIDS Service Organizations (ASOs), grantees of the initiative ConnectHIV in the United States, developed a theoretical model of five categories of factors – external, community, organizational, staff, and client – that lead to effective service integration (SI) and took part in a self-assessment related to the model. The model was tested empirically using GEE analysis to assess the effect of ASO SI scores on client outcomes from participation in HIV/AIDS interventions involving case management with persons living with HIV/AIDS. Results showed that clients served by ASOs with more effective SI were more knowledgeable of HIV disease, healthier (higher CD4, lower viral load) and perceived themselves as healthier than clients in ASOs with less effective SI. In addition, clients at ASOs with more effective SI more often showed stronger gains in CD4 count over their time in the HIV/AIDS intervention than those at ASOs with less effective SI. Further research is needed on models and measurement of SI in order to effectively investigate the impact of HIV SI on client health outcomes.

Keywords:

• HIV
• AIDS
• service integration
• PLWHA
• case management

Acknowledgements

The authors would like to thank the ConnectHIV grantees and their clients for their contribution to the work discussed in this publication – the Black Coalition on AIDS, STOP AIDS Project, AIDS Interfaith Residential, Latino Commission on AIDS, BEBASHI, St. Hope Foundation, Northeast Florida AIDS Network, New York Harm Reduction Educators, Prevention Point Philadelphia, Cal-Pep, Foothill AIDS Project, Positive Impact, AIDS Care Services, Hyacinth AIDS Foundation, Piedmont Health Care Consortium, Philadelphia FIGHT, Shanti Project, The Family Center, Chicago House and Social Service Agency, and Test Positive Aware Network. We would also like to thank Atiya Weiss formerly at the Pfizer Foundation for the opportunity to provide support to the ConnectHIV project and to David Holtgrave at Johns Hopkins University and to Sally Munemitsu and Janice Brown at TCC for their support throughout the evaluation. While preparing this article, the authors’ salaries were supported in part by a grant from the Pfizer Foundation as part of its ConnectHIV program.