Longitudinal associations between case management and supportive services use among black and Latina HIV-positive women in New York City.
BACKGROUND
The literature analyzing the relationship between case management and supportive service use longitudinally among African American and Latina HIV-positive women is limited.


METHODS
This retrospective analysis of participant case management, supportive service, and medical charts sought to examine both descriptive and relational data on use of case management and supportive services over a 2-year period from 2002 to 2005 and to analyze moderating person- level or institution-level factors.


RESULTS
The analyzed case management, supportive service, and medical charts revealed that participants interacted with their case manager four times and received 3.6 supportive services per month. Transportation, primary healthcare/medical specialists, and support groups were the services most used, with rates ranging from 70% to 80%. Using hierarchical linear modeling (HLM), the unconditional growth models showed that case management and supportive service use patterns remained constant over the 24-month period. Additionally, the multivariate unconditional model suggests a significant positive relationship between case management and supportive services. No moderation was indicated in the association between case management and supportive service use by person-level (e.g., mental illness, substance use) and institution-level (i.e., service delivery model) factors.


CONCLUSIONS
Participants use supportive and case management services in a similar manner based on individual need. This synergistic relationship suggests that increases in either may result in retaining women in care. Implications for service delivery point to the need for skills building training for case managers, outreach workers, or system navigators to assist with short-term goals of establishing rapport and maintaining the client relationship, as this may lead to HIV-positive women accessing services. Additionally, outreach and engagement strategies need to be developed for those who typically underuse these services.
Halkitis
Perry N
PN
Center for Health, Identity, Behavior, and Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA. Perry.Halkitis@nyu.edu
Kupprat
Sandra A
SA
Mukherjee
Preetika Pandey
PP
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D019090:Case Management / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006679:HIV Seropositivity / Q000208:ethnology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D009519:New York City / Q000453:epidemiology; D012189:Retrospective Studies; D012944:Social Support; D012947:Social Work / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*