Background:
Comorbidity rates and service needs are high among people living with HIV/AIDS (PLWHA). The
effects of service utilization and unmet service needs on antiretroviral therapy (ART) adherence are not well understood.
The purpose of this study was to investigate associations among PLWHA’s service utilization, unmet service needs, and
ART adherence.
Methods:
PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment project in 2016.
Participants completed a self-administered questionnaire on paper or online. The independent variables were service utilization and unmet service needs. The outcome variable was ART adherence. Multivariable logistic regression analyses were
conducted to examine associations between the amount of utilized services and unmet service needs with ART adherence.
Results:
Only 12 (7.5%) participants reported they received all needed services. The ART non-adherence group showed
significantly higher unmet medical service needs compared to the ART adherence group (p=0.007). Unmet medical service
needs (Adjusted Odds Ratio (AOR) 0.69, CI 0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were
negatively associated with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART adherence.
Conclusion:
The results of this study indicate that health promotion programming should focus not only on introducing new
services at the community level, but also work to optimize the availability and awareness of current services. Furthermore,
health promotion programs should focus on filling service coverage gaps and improving the facilitation of services.
Healthcare utilization, unmet service needs and linkage to care among people living with HIV/AIDS
