SELF-PERCEIVED UNMET HEALTH-CARE NEEDS OF PERSONS ENROLLED IN HIV CARE

We examined the prevalence of, and factors associated with unmet healt h service needs among persons with HIV disease. Data were examined fro m 1,851 participants in the U.S. AIDS Cost and Service Utilization Stu dy, drawn from 26 medical care providers in 10 cities. Geographic area s with large numbers of AIDS cases, and health care providers within t hem were chosen as study sires. After completing a screener questionna ire, potential participants at each site were stratifed by illness sta ge, HIV exposure route, and insurance status; a systematic random samp le within those strata were selected for the study. Participants compl eted a comprehensive survey of HIV-related service use and costs, whic h also asked them to identify unmet health service needs. Analyses ide ntified the relationship between unmet needs and: stage of illness, ty pe of insurance, source of care, living arrangement, and AIDS prevalen ce of respondents' geographic region. At least one unmet need was repo rted by 20% of the sample. Needs for non-institutional services, e.g., dental care, mental health, and medications were more likely to be un met than need for emergency room and hospital care. While most factors significantly affected the odds of having an unmet need, the greatest effects were found for private insurance and HIV asymptomatic status, both of which decreased the odds of unmet needs by approximately 50%. These findings suggest that insurance coverage for services required during the chronic phase of HIV illness is inadequate and should be au gmented.