Ryan White Title IIConsumer Needs Assessment

Southwest/Piedmont HIV Care ConsortiumHIV/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

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

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

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.

Section I

Demographics of Survey Respondents

Mostly males

GENDER Male 58.8%

[127] Female 34.3%

[74] Trans.Male to Female .5%

[1] Trans. Female to Male .5%

[1]

127

74

1

113

Male

Female

Male to Female

Transgendered

Female to Male

Transgendered

Missing in System

Majority between ages of 40-49

0

10

20

30

40

50

60

70

80

90

0-19 20-29 30-39 40-49 50-59 60+

More People in the 40-49 Age Range Participate in Ryan White

Survey

Number

Mostly Caucasian

Race

87

112

1

2

4African American

Caucasian/White

Asian

Pacific/Islander

Native

American/Alaskan

Other

48.1% report college experience

Educational Attainment

0

20

40

60

80

Number 51 51 64 29 11

Less than 12th Grade High School Some College Undergraduate Degree PostgraduateDegree

47.2% on disabilityEmployment

49

17

15

8

102

9

5

0 20 40 60 80 100 120

Full time

Part time

Unemployed looking for work

Unemployed waiting on disability

On disability

Retired

Other

44.4% have incomes of $10,000 or less

Total Household Income

96

59

28

7

5 Less than

$10,000

$10,001-

$20,000

$20001 to

$30,000

$30,001-

$50,000

$50,000 and

above

22.7% have no health insurance

49

57

54

34

9

1

45

None

Medicaid

Medicare

Medicaid and

Medicare

Medicare and

Supplemental

Veteran’s Benefits

Private

Insurance

Section 2

Primary HIV Positive and AIDS Information

63.4% report having sex with men

Method of Acquiring HIV Status

020406080

100120140160

Havin

g S

ex

with M

en

I D

on't

Know

Havin

g S

ex

with

Wom

en

Sharing

Needle

s o

r

Work

s

Blo

od

Pro

ducts

or

Tra

nsfu

sio

n

Born

HIV

Infe

cte

d

Occupation

Exposure

Men having sex with men

41.2% were diagnosed by doctors

AIDS Diagnosed by Doctor

89

110

8

Yes

No

Don't Know

57.9% experience symptoms of HIV

Have Had Symptoms of HIV

125

71

17

0

20

40

60

80

100

120

140

Yes No Don't Know

Section 3

HIV Positive/AIDS Services Information

74.9% receive care within 6 months

Length of Time to Start Receiving Services

After Testing Positive

104

54

9

44

0

20

40

60

80

100

120

Within a month 1-6 months More than 6 months More than 1 year

Importance of early care/being afraidWhat Would have Helped to get Services Sooner

141

38

9

25

11

32

18.0

Nothing- I got help right

away

Knowing how important

early care was

Not having to take care

of family or others

Knowing who to

call/where to go

Not using drugs or

alcohol

Not being so Afraid

Other

Ryan White reaches 78.7% with services

Currently Receiving RW Services

0

20

40

60

80

100

120

140

160

180

Yes No Don't Know

55.6% visit doctor 3 or more times yearly

In the Last Year, How Often have You Seen

Your Doctor about HIV?

9

29

120

53

Never

1-2 times

3-4 times

More than 4 times

Transportation interferes with visits

If You have not Seen a Doctor in the Last Year, Why?

10

3

37

3 3

23

0

5

10

15

20

25

30

35

40

Emergency room visits are few

Emergency Room Visits Because of HIV/AIDS

176

27

12

None

1-2

More than 2

81.5% feel the same or better

Physical Health Compared to a Year Ago

37

94

82

0

10

20

30

40

50

60

70

80

90

100

WorseSame Better

Section 4

Knowledge and Information about HIV+/AIDS

92.1% say it’s easy to talk with doctors

Easy to Talk with Doctors about HIV Treatment

202

13

Yes

No

79.2% say doctors explain things clearly

Doctor Explains Things Clearly

207

6

0

50

100

150

200

250

Yes No

89.8% know consequence of missed drugs

Informed about Missed Doses of HIV Drugs

197

17

0

50

100

150

200

250

Yes No

Doctors/Practitioners information source

Who Gave You the Most Information About HIV+/AIDS

170

47

38

18

18

11

20

13

Your doctor/nurse

practitioner

Nurse/Other healthcare

worker

Case manager/Social

worker

Friends

Support groups

Newspaper/Books

Internet

Other

Doctors Give HIV+ Information

Doctor has Discussed HIV Prevention

199

13

Yes

No

77.8% enrolled in Ryan White

Currently Enrolled in RW Services

0

20

40

60

80

100

120

140

160

180

Yes No Don't Know

Doctor visits/lab services top list

Number of People Reporting Priority of Services Offered

Services needed - not offered

Number of People Reporting Priority of Services Not Offered

Section 5

Consumer Needs

Health care unmet needs

0 50 100 150 200

Laboratory tests related to HIV

See a Doctor or a Specialist

Dental care

Eye care

Help paying for medications

See a Mental Health Counselor

Advice on nutrition/healthy eating

Home med. and health supplies

Physical therapy

Home health care

Other rehabilitative therapy

Children’s HIV care

Stay in a Nursing Home

Enroll in Hospice Care

Health Care Needs and Unmet Needs

NeedUnmet Need

Get Help with Insurance Premium

Support services need/unmet need

0 20 40 60 80 100 120

Case management

Get Food

Education about HIV Treatments

Support groups

Legal assistance or advice

Get Transportation to Medical Apts

An advocate (peer, lawyer)

Spiritual counseling/support

Get education/non-medical HIV Serv

Help taking my HIV Drugs

Grief counseling

Help with translations/interpreting

Get Childcare

Support Services Needs and Unmet Needs

Needs

Unmet Needs

Other services needs/unmet needs

0 20 40 60 80

Assistance with paying Utilities

Help applying for Food Stamps

Get Emergency Food

Emergency payments for housing

Help with Private Insurance

Short Term Housing Assistance

Information about Alternative Meds

Financial Counseling

Clothing

Volunteer companion (buddy)

Household helpers

Pet care

Domestic Violence Services

Employment training/counseling

Needs

Unmet Needs

Barriers to care

0 10 20 30 40 50 60

Do Not Know where to go for servicesServices unavailable

Fear of disclosing HIV+ statusToo much income to qualify

Cost of medications/services

Transportation to servicesConfidentiality issue(s) with service provider

Long waiting listLong wait to be seen at the clinicSexual Orientation Discrimination

Gender DiscriminationRacial discrimination

Language barrierLack of childcare

Sexual Identity Discrimination

Barriers to Care

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.”    

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

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