Unmet Need Estimate

Needs Assessment Committee December 2010 JoAnn Hilger, MPH Ryan White Grant Administrator 1

FY2011 Grant Application Focus

Demonstrated need and early identification of individuals with HIV/AIDS (EIIHA) RW program activities should support the three primary goals of the National HIV/AIDS Strategy – Reduce number of people who become infected with HIV – Increase access to care and optimize health outcomes for PLWHA – Reduce HIV-related health disparities 2

Demonstrated Need Describes How PC Considers or Uses:

HIV/AIDS epidemiology data Cost data Unmet need data How MAI funding will enhance services to minority populations Data related to persons unaware of HIV status 3

HRSA Definition

Unmet Need for Health Services, also referred to as unmet need, is the need for HIV related Health Services by individuals with HIV who are aware of their HIV status, but are not receiving regular primary health care.

– Regular care as defined by HRSA is evidence of one primary care visit in a 12-month period 4

Data Used

– Public health surveillance data are used to compare the number of people with diagnosed with HIV or AIDS as of December 2008 with the number of PLWHA presumed to be in care based on mandatory reporting of all CD4 and viral load tests completed in calendar year 2009. – Cases reported to DOHHM were excluded if they Resided outside of NYC or had an unknown borough of residence at the time of diagnosis, or Had evidence of residence outside of NYS in 2009 based on state and date of HIV/AIDS diagnosis.

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Estimate

38% of PLWH and 33% of PLWA did not receive HIV primary care in 2009 35% of PLWHA did not receive HIV primary care in 2009 The estimate of PLWHA not receiving specified primary care in 2007 – 2009 remained relatively constant ranging from 33- 35% 6

Demographics and Location of PLWHA Not in Care

Persons living with HIV (37.6%) are more likely to be out of care than persons living with AIDS (32.9%) Male PLWHA are more likely to be out of care than females (36.3% vs. 31.2%) White PLWHA (37%) are more likely to be out of care than Blacks (34.7%) and Hispanics (33.3%) Queens had highest percentage of PLWHA out of care – 39.3% 7

Use of Estimate in Planning

Assessment of service needs, gaps, and barriers to care for people not in care.

Efforts to identify individuals not in care and assist them in accessing primary care. Results of the Unmet Need Framework is reflected in the planning and decision making process to determine priorities, resource allocations and the system of care. 8