Service Delivery and Patient Outcomes in Ryan White HIV/AIDS Program-Funded and -Nonfunded Health Care Facilities in the United States

Outpatient human immunodeficiency virus (HIV) health care facilities receive funding from the Ryan White HIV/AIDS Program (RWHAP) to provide medical care and essential support services that help patients remain in care and adhere to treatment. Increased access to Medicaid and private insurance for HIV-infected persons may provide coverage for medical care but not all needed support services and may not supplant the need for RWHAP funding.

Overall, 34.4% of facilities received RWHAP funding and 72.8% of patients received care at RWHAP-funded facilities. With results reported as percentage, patients attending RWHAP-funded facilities were more likely to be aged 18 to 29 years, female, black or Hispanic, have less than a high school education, income at or below the poverty level, and lack health care coverage. 

The RWHAP-funded facilities were more likely to provide case management as well as mental health, substance abuse, and other support services; patients attending RWHAP-funded facilities were more likely to receive these services. After adjusting for patient characteristics, the percentage prescribed ART antiretroviral therapy, reported as adjusted prevalence ratio, was similar between RWHAP-funded and non-RWHAP-funded facilities, but among poor patients, those attending RWHAP-funded facilities were more likely to be virally suppressed.

A total of 72.8% of HIV-positive patients received care at RWHAP-funded facilities. Many had multiple social determinants of poor health and used services at RWHAP-funded facilities associated with improved outcomes. Without facilities supported by the RWHAP, these patients may have had reduced access to services elsewhere. Poor patients were more likely to achieve viral suppression if they received care at a RWHAP-funded facility.

Via: http://ht.ly/S9NB8 

By: Weiser J1, Beer L1, Frazier EL1, Patel R2, Dempsey A3, Hauck H3, Skarbinski J4.

• 1Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
• 2Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia2Health Information and Technology Systems, ICF International, Atlanta, Georgia.
• 3HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, Maryland.
• 4Division of Global HIV/AIDS and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia.