Social Services Utilization and Need Among a Community Sample of Persons Living With HIV in the Rural South

The authors introduced the current study by noting that HIV prevalence has grown faster in the US South than in other regions, and Southern people living with HIV (PLWHIV) "are often rural, impoverished or otherwise under-resourced." Research on HIV patients in urban settings and on those receiving medical care suggests that both quality of life and some medical outcomes can be improved through the use of social services. Little is known, however, about the patterns of social service utilization and need among HIV patients in the rural South.

In 2007, the AIDS Alabama needs assessment survey sampled a diverse community cohort of 476 adults with HIV who were representative of the state's HIV-positive population: 66 percent male, 76 percent black, and 26 percent with less than a high school education. The authors developed service utilization/need (SUN) scores for each of 14 social services; regression models were used to determine demographic predictors of the persons most likely to need each service. They then conducted an exploratory factor analysis to determine whether certain services clustered together for the sample.

The services most commonly used, or needed, by respondents were case management, help accessing medical care, and financial assistance. Black respondents were more likely to have higher SUN scores for alcohol treatment and for assistance related to employment, housing, food, financial, and pharmacy needs. Those respondents who reported no spousal or partner relationships had higher SUN scores for substance use treatment.

Females were more likely to have higher SUN scores for childcare assistance, while black respondents and the unemployed were more likely to have SUN scores in the highest quartile of the overall score distribution.

"Factor analysis yielded three main factors: basic needs, substance use treatment, and legal/medical needs. These data provide important information about rural Southern PLWHIV and their needs for ancillary services," the authors concluded. "They also suggest clusters of service needs that often occur among PLWHIV, which may help case managers and other service providers work proactively to identify important gaps in care."

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