1. Ryan White Title II Consumer Needs Assessment Southwest/Piedmont HIV Care Consortium HIV/STD Resources November 2007

2. Living with HIV or AIDS - 2007  22 million people worldwide  18,814 people in Virginia  1,430 people in the Southwest Region of Virginia

3. HIV consumer needs assessment  Provides the Southwest/Piedmont HIV Care Consortium with a management tool to maximize the effectiveness and efficiency of HIV services  Satisfies the requirement that the Southwest/Piedmont HIV Care Consortium, a Part B Consortium, carry out an assessment of needs as outlined in the Ryan White HIV/AIDS Treatment Modernization Act of 2006

4. Purpose of the assessment  To identify issues and concerns of individuals living with HIV/AIDS in Health Region III of Virginia  Information is used by the Consortium to ensure effective and efficient planning, for implementation and evaluation of HIV health and social services in Southwest Virginia

5. Methodology  In October 2007 - six hundred seventy four(674) consumer surveys were distributed to 7 Ryan White Title II subcontractors in Southwest Virginia  Surveys were then distributed via case managers to clients between October 1 and October 31, 2007.  The four-page survey contained both closed and open-ended questions.  Self-addressed envelopes were provided for clients who chose to return the survey individually.   A total of two hundred seventeen (217) clients returned the consumer survey for a response rate of 32% of Ryan White clients.

6. Section I Demographics of Survey Respondents

7. Mostly males  GENDER  Male 58.8% [127]  Female 34.3% [74]  Trans.Male to Female.5% [1]  Trans. Female to Male.5% [1] 127 74 1 1 13 Male Female Male to Female Transgendered Female to Male Transgendered Missing in System

8. Majority between ages of 40-49 0 10 20 30 40 50 60 70 80 90 0-1920-2930-3940-4950-5960+ More People in the 40-49 Age Range Participate in Ryan White Survey Number

9. Mostly Caucasian Race 87 112 1 2 4 African American Caucasian/White Asian Pacific/Islander Native American/Alaskan Other

10. 48.1% report college experience Educational Attainment 0 20 40 60 80 Number 51 642911 Less than 12 th GradeHigh SchoolSome College Undergraduate DegreePostgraduate Degree

11. 47.2% on disability Employment 49 17 15 8 102 9 5 020406080100120 Full time Part time Unemployed looking for work Unemployed waiting on disability On disability Retired Other

12. 44.4% have incomes of $10,000 or less Total Household Income 96 59 28 7 5Less than $10,000 $10,001- $20,000 $20001 to $30,000 $30,001- $50,000 $50,000 and above

13. 22.7% have no health insurance 49 57 54 34 9 1 45 None Medicaid Medicare Medicaid and Medicare Medicare and Supplemental Veteran’s Benefits Private Insurance

14. Section 2 Primary HIV Positive and AIDS Information

15. 63.4% report having sex with men

16. Men having sex with men

17. 41.2% were diagnosed by doctors AIDS Diagnosed by Doctor 89 110 8 Yes No Don't Know

18. 57.9% experience symptoms of HIV Have Had Symptoms of HIV 125 71 17 0 20 40 60 80 100 120 140 YesNo Don't Know

19. Section 3 HIV Positive/AIDS Services Information

20. 74.9% receive care within 6 months Length of Time to Start Receiving Services After Testing Positive 104 54 9 44 0 20 40 60 80 100 120 Within a month1-6 monthsMore than 6 monthsMore than 1 year

21. Importance of early care/being afraid What Would have Helped to get Services Sooner 141 38 9 25 11 32 18.0 Nothing- I got help right away Knowing how important early care was Not having to take care of family or others Knowing who to call/where to go Not using drugs or alcohol Not being so Afraid Other

22. Ryan White reaches 78.7% with services Currently Receiving RW Services 0 20 40 60 80 100 120 140 160 180 YesNo Don't Know

23. 55.6% visit doctor 3 or more times yearly In the Last Year, How Often have You Seen Your Doctor about HIV? 9 29 120 53 Never 1-2 times 3-4 times More than 4 times

24. Transportation interferes with visits

25. Emergency room visits are few Emergency Room Visits Because of HIV/AIDS 176 27 12 None 1-2 More than 2

26. 81.5% feel the same or better Physical Health Compared to a Year Ago 37 94 82 0 10 20 30 40 50 60 70 80 90 100 Worse SameBetter

27. Section 4 Knowledge and Information about HIV+/AIDS

28. 92.1% say it’s easy to talk with doctors Easy to Talk with Doctors about HIV Treatment 202 13 Yes No

29. 79.2% say doctors explain things clearly Doctor Explains Things Clearly 207 6 0 50 100 150 200 250 YesNo

30. 89.8% know consequence of missed drugs Informed about Missed Doses of HIV Drugs 197 17 0 50 100 150 200 250 YesNo

31. Doctors/Practitioners information source Who Gave You the Most Information About HIV+/AIDS 170 47 38 18 11 20 13 Your doctor/nurse practitioner Nurse/Other healthcare worker Case manager/Social worker Friends Support groups Newspaper/Books Interne t Other

32. Doctors Give HIV+ Information Doctor has Discussed HIV Prevention 199 13 Yes No

33. 77.8% enrolled in Ryan White Currently Enrolled in RW Services 0 20 40 60 80 100 120 140 160 180 YesNo Don't Know

34. Doctor visits/lab services top list Number of People Reporting Priority of Services Offered

35. Services needed - not offered Number of People Reporting Priority of Services Not Offered

36. Section 5 Consumer Needs

37. Health care unmet needs

38. Support services need/unmet need

39. Other services needs/unmet needs

40. Barriers to care

41. Summary Overall, the 2007 Ryan White Client Needs Survey indicates that clients are pleased with the services they are provided and that these services result in more needs being met than not. Areas of need that consistently show are financial in nature and may be a reflection of the relatively low levels of annual income reported by the respondents. Finally, more attention needs to be given to removing the barrier of “Not knowing where to go for services.” 

42. Ryan White Program In 1991 the Council of Community Services became lead agent for the Southwest/Piedmont HIV Care Consortium (S/PHCC) in central, Southside and Southwest Virginia. This coalition of agencies and individuals has provided HIV medical care and support services through local subcontractor sites in Covington, Danville, Floyd, Giles, Lynchburg, Marion, Christiansburg, Pulaski, Roanoke and Radford

43. HIV Resource and Training Center  Robert (Rob) Morrow is the Director of the HIV Resource and Training Center. He is a leading authority on HIV and AIDS in the Commonwealth of Virginia and across the United States. For more information regarding the Ryan White Program, the Southwest/Piedmont HIV Care Consortium or the Virginia HIV/AIDS Resource and Consultation Center, contact robertm@councilofcommunityservices.org