Krause Denise D, May Warren L, Butler Kenneth R
School of Dentistry, University of Mississippi Medical Center, Jackson, MS, USA.
AIDS Care. 2013 Aug;25(8):973-9. doi: 10.1080/09540121.2012.748880. Epub 2012 Dec 19.
A statewide needs assessment of persons living with HIV/AIDS (PLWHA) was conducted to determine what is known about access to care, utilization of services, and perceived barriers to receiving care and services. Our objective was to determine which needs were being met or unmet among PLWHA in Mississippi to provide a better understanding of how effectively to allocate funding to provide for the needs of that group. In this cross-sectional study, a true random sample of PLWHA in Mississippi was interviewed in 2005-2006. Questions were asked to identify opinions about respondents' experiences with 23 health care services and 30 public or private assistance services. The kappa statistic was used to measure agreement between level of services needed and level of services provided. Services with the lowest kappa scores revealed which services were being either mostly unmet, or even overly met. Greatest service needs were HIV viral load test, Pap smear, CD4/T-cell count test, and medication for HIV/AIDS, which were reasonably well met. The most significantly unmet needs were dental care and dental exams, eye care and eye exams, help paying for housing, subsidized housing assistance, mental health therapy or counseling, access to emotional support groups, and job placement or employment. Overly met services included medical care at a physician's office or clinic and free condoms. This study identified needs perceived to be significantly unmet by PLWHA, as well as areas that were perceived to be adequately or overly met. This information may be used to target areas with the greatest impact for improvement and provide insight into how to effectively allocate health care resources and public/private assistance.
开展了一项针对该州艾滋病毒/艾滋病感染者（PLWHA）的需求评估，以确定在获得护理、服务利用以及接受护理和服务的感知障碍方面的已知情况。我们的目标是确定密西西比州的艾滋病毒/艾滋病感染者中哪些需求得到了满足或未得到满足，以便更好地了解如何有效地分配资金以满足该群体的需求。在这项横断面研究中，2005年至2006年对密西西比州的艾滋病毒/艾滋病感染者进行了真正的随机抽样访谈。询问了关于受访者对23项医疗服务和30项公共或私人援助服务体验的看法。kappa统计量用于衡量所需服务水平与提供的服务水平之间的一致性。kappa得分最低的服务揭示了哪些服务大多未得到满足，甚至过度得到满足。最大的服务需求是艾滋病毒载量检测、巴氏涂片检查、CD4/T细胞计数检测以及艾滋病毒/艾滋病药物治疗，这些需求得到了较好的满足。最明显未得到满足的需求是牙科护理和牙科检查、眼科护理和眼科检查、住房费用支付帮助、补贴住房援助、心理健康治疗或咨询、获得情感支持小组以及工作安置或就业。过度得到满足的服务包括在医生办公室或诊所的医疗护理以及免费避孕套。这项研究确定了艾滋病毒/艾滋病感染者认为明显未得到满足的需求，以及被认为得到充分满足或过度满足的领域。这些信息可用于针对具有最大改善影响的领域，并深入了解如何有效地分配医疗资源以及公共/私人援助。
