Prevalence and predictors of unmet need for supportive services among HIV-infected persons: Impact of case management

BACKGROUND. Previous research has indicated that the needs of persons infec ted with human immunodeficiency virus (HIV) for supportive services often g o unmet, Although case management has been advocated as a method of decreas ing unmet needs for supportive services, its effectiveness is poorly unders tood. OBJECTIVES. To assess the prevalence of need and unmet need for supportive services and the impact of case managers on unmet need among HN-infected pe rsons. RESEARCH DESIGN. National probability sample. PARTICIPANTS. A total of 2,832 HIV-infected adults receiving fare. MEASURES. Need and unmet need for benefits advocacy, housing, home health, emotional counseling, and substance abuse treatment services. RESULTS. Sixty-seven percent of the sample had a need for at least one supp ortive service, and 26.6% had an unmet need for at least one service in the previous 6 months. Contingent unmet need (unmet need among persons who nee ded the service) was greatest for benefits advocacy (34.6%) and substance a buse treatment (27.6%). Fifty-seven percent of the sample had had contact w ith their case manager in the previous 6 months. In multiple logistic regre ssion analysis, with adjustment for covariates, having a case manager was a ssociated with decreased unmet need for home health care (OR = 0.39; 95% CI = 0.25-0.60), emotional counseling (OR = 0.54; 95% CI = 0.38-0.78), and an y unmet need (OR = 0.70; 95% CI = 0.54-0.91). An increased number of contac ts with a case manager was significantly associated with lower unmet need f or home health care, emotional counseling, and any unmet need. CONCLUSIONS. Need and unmet need for supportive services among HIV-infected persons is high. Case management programs appear to lower unmet need for s upportive services.