Social and Clinical Determinants Influencing HIV Treatment Among Hoosiers

Abstract

Indiana, with an estimated 9,282 persons living with HIV/AIDS in 2008, was selected to participate in the Medical Monitoring Project. The Medical Monitoring Project is a surveillance system designed to generate representative data on persons living with HIV/AIDS who are receiving care in Indiana. The authors sought to answer: What obstacles exist today among persons receiving HIV medical care? What impact do these have on treatment and services? Of 451 participants sampled, 349 reported at least one service need during the past year and 164 (47.0%) of those participants reported at least one service need was unmet. Overall, reported unmet needs was significantly associated (p < .034) with a lower likelihood of “always” taking HIV medications. The study results indicate that obstacles to treatment adherence involve unmet needs commonly found among HIV-infected persons receiving care. Interventions to improve treatment adherence involve community service assessments, client awareness, linkage to services, and provider awareness of existing barriers.

KEYWORDS:

• AIDS
• care
• HIV
• MMP
• treatment
• unmet needs

Acknowledgments

This report was supported by a Cooperative Agreement from the Centers for Disease Control and Prevention. The authors would like to acknowledge contributing staff from the Indiana State Department of Health and fellow colleagues from the Indiana University School of Medicine, Department of Public Health. Particularly, we would like to acknowledge Matthew Richey, an epidemic intelligence service officer from the U.S. Public Health Service Commissioned Corps, and Brittney Carelock, a graduate student from the Indiana University School of Medicine, Department of Public Health.

Notes

^a Source: American Community Survey, 2008, U.S. Census Bureau; http://www.census.gov Indiana State Department of Health, Division of HIV/STD/Viral Hepatitis; http://www.in.gov/isdh/23266.htm.

*Unmet Needs was measured by using a bivariate analysis and P-values were calculated using Pearsons Chi-Square Test.

**Medication Adherence was measured by using a Step-Wise Logistic Regression model and P-values were calculated using Pearsons Chi-Square Test. The model Goodness-of-Fit was measured by the Hosmer and Lemeshow Test.

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