title: Association of unmet needs for support services with medication use and adherence among HIV-infected individuals in the southeastern United States.
abstract: Unmet needs for services, such as housing and psychiatric treatment, are relatively common among HIV-infected individuals; however, the effects of different types of unmet needs on health-care outcomes are not well understood. This study describes unmet psychosocial needs and their relationship with health-care outcomes among individuals receiving HIV care in the southeastern US (n=526). We used multivariate logistic regression to examine the association of seven categories of unmet needs with HIV medication use and adherence. Most participants (84.5%) reported at least one service need in the past year. Nearly half (47%) of participants with service needs reported that at least one need was not met. Participants with one or more unmet needs were less likely to be taking any HIV medications (p = 0.007) and reported poorer medication adherence (p=0.013). The specific unmet needs for benefits (including Social Security, health insurance and prescription coverage) (p = 0.006) and a support group (p=0.040) were associated with being less likely to be taking any HIV medications. Unmet need for mental health-related counseling was associated with poorer medication adherence (p=0.003). Study findings regarding the high level of unmet need and the association of unmet need with poorer outcomes illustrate the importance of interventions to address these needs.
authors.affiliation: Duke University Center for Health Policy, Law and Management, Health Inequalities Program, Durham, NC 28207, USA. Sreif@hpolicy.duke.edu
authors.forename: S
authors.initials: S
authors.lastname: Reif
authors.forename: K
authors.initials: K
authors.lastname: Whetten
authors.forename: K
authors.initials: K
authors.lastname: Lowe
authors.forename: J
authors.initials: J
authors.lastname: Ostermann
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D020380:Needs Assessment; D010349:Patient Compliance; D012944:Social Support; D015144:Southeastern United States
chemical_list: D019380:Anti-HIV Agents