WEPE098 - Poster Exhibition
Comparison of Ryan White Care Act-funded versus non-Ryan White-funded HIV outpatient facilities in the United States: medical monitoring project, 2009
J. Weiser, A. Do, L. Beer, J. Skarbinski
Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, Atlanta, United States
Background: Supplemental support services in HIV outpatient healthcare facilities, such as those funded by the Ryan White CARE Act, are associated with improved patient retention, treatment adherence, and clinical outcomes and with decreased HIV transmission. We characterized the availability of these services at facilities receiving and not receiving Ryan White funding (RWF).
Methods: The Medical Monitoring Project (MMP) is a clinical surveillance project conducted in 23 public health jurisdictions in the United States and Puerto Rico. As part of MMP, we created a comprehensive list of all HIV facilities in each state participating in MMP and then selected a probability sample of facilities in each area to produce nationally representative estimates of characteristics of HIV care facilities. Differences in the availability of supplemental services across facility types and RWF status were assessed with bivariate analyses.
Results: Of 606 eligible facilities, 232 (38.3%) received RWF. Among these, 93 (40.1%) were community health centers, 40 (17.2%) were community-based organizations, 38 (16.4%) were health departments; and 38 (16.4%) were private practices. Among 293 facilities not receiving RWF, 221 (75.4%) were private practices. Compared to facilities not receiving RWF, those that did were more likely to provide on-site medication adherence consultation (87.9% vs. 39.3%, p< .0001), case management (82.8 vs. 16.4%, p< .0001), social services (64.7% vs. 15.0%, p< .0001), language translation (65.1% vs. 22.9%, p< .0001), mental health counseling (71.1% vs. 18.4%, p< .0001), substance abuse treatment (39.7% vs. 12.6%, p< .0001), dental care (45.7% vs. 9.0%, p< .0001), nutrition consultation (70.3% vs. 21.5%, p< .0001), and risk-reduction counseling by professional counselors (82.3% vs. 26.3%, p< .0001).
Conclusions: Less than half of U.S. HIV outpatient facilities receive RWF. However, facilities receiving RWF provide more comprehensive support services than those without RWF. RWF is associated with the provision of key components of successful HIV care and prevention services.
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