Unmet needs for ancillary care services are associated with HIV clinical outcomes among adults with diagnosed HIV

ABSTRACT

Ancillary care services are essential for supporting care engagement and viral suppression among persons with HIV. Estimating unmet needs for ancillary care services may help address care barriers and improve clinical outcomes, but recent, nationally representative estimates are lacking. Using CDC Medical Monitoring Project data from 2015–2018, we report representative estimates of unmet needs for ancillary care services and associations with HIV clinical outcomes among U.S. adults with HIV. Data were collected through interview and medical record abstraction. We described weighted percentages for all characteristics and associations with HIV clinical outcomes using prevalence ratios with predicted marginal means, adjusting for potential confounding. Substantial unmet needs were reported; unmet needs were higher among persons with social determinants of poor health, persons who engaged in drug use or binge drinking, and those who experienced depression or anxiety. Having unmet needs for care was associated with adverseHIV clinical outcomes, with a dose response effect between number of unmet needs and outcomes. Expanding ancillary care access based on a comprehensive care model, strengthening partnerships between providers to connect patients to essential services, and tailoring services based on need may help reduce disparities in unmet needs and improve outcomes.

KEYWORDS:

• HIV
• unmet needs
• HIV care continuum
• social determinants of health
• Ryan White HIV/AIDS Program

Acknowledgments

We acknowledge local MMP staff, health departments, and participants, without whom this research would not be possible. Author contributions: Sharoda Dasgupta conceived of and designed the analysis and wrote the paper; Yunfeng Tie led the analysis and critically reviewed the paper; Linda Beer provided key input for the analysis and critically reviewed the paper; John Weiser provided key input for the analysis and critically reviewed the paper. The Medical Monitoring Project was funded by CDC.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Medical Monitoring Project was funded by the Centers for Disease Control and Prevention.