Men who have sex with men (MSM) living with human immunodeficiency virus (HIV) have many unmet ancillary healthcare needs, with young black and Hispanic men having the greatest deficits, according to the Centers for Disease Control (CDC) and Prevention’s Morbidity and Mortality Weekly Report.1 Researchers defined ancillary healthcare as “services that support retention in routine HIV medical care and assist with day-to-day living.”
Nicholas P. DeGroote, MPH, of the Division HIV/AIDS Prevention at the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the CDC and colleagues used the surveillance of the Medical Monitoring Project’s (MMP) data during 2013-2014 to gather information about behavioral and clinical characteristics of men with HIV. Researchers used the data to make national estimates about unmet ancillary medical needs and the reasons for them.
Researchers reported that from 2013-2014, 23% of MSM affected with HIV needed dental care, and 19% needed vision care. “The most common reasons for unmet needs were inadequate knowledge or insufficient resources for obtaining services.”
Mr DeGroote and colleagues explained that vision and dental care are especially important for men living with HIV because they often suffer from eye and oral conditions, such as candidiasis and Kaposi’s sarcoma, which require specialized care.
Implementing plans that increase patient knowledge on how to get ancillary services could improve access for all races and ethnic populations, which would decrease the disparities in care and improve health for all men living with HIV.
Mr DeGroote and colleagues also noted the challenges patients living with HIV encounter. About half have incomes at or below the poverty line, 8% are homeless and 18% are uninsured. “Ancillary services, including food or nutrition, transportation assistance, and shelter or housing, are fundamental for accessing medical care, adhering to HIV treatment, and being virally suppressed,” researchers explained.
In addition to lack of knowledge about ancillary services, researchers cited men not being eligible for services, denial of services, and psychological barriers as obstacles in getting assistance.
The study listed 4 limitations. Data was not transferrable to MSM who do not seek medical care for HIV or were unaware of their infection. Ancillary service needs were not objectively evaluated because they were self-reported, and unmet needs probably varied by geographic location.
In an interview with Infectious Disease Advisor, Mr DeGroote said, “Infectious disease doctors can increase patient access to ancillary services through active referral systems to these services and by staying up-to-date on how patients can access these services in their communities.” He added, “Health providers can also partner with local and state health departments and community-based organizations offering ancillary services. Last, promoting ancillary services passively using brochures and waiting room signage may also help to increase patient awareness of available ancillary services.”
During the interview, Mr DeGroote emphasized, “Previous research has shown that ancillary services can increase retention in HIV medical care and improve clinical outcomes for persons living with HIV.” He said that the study showed a great amount of unmet needs for ancillary services among MSM with HIV who receive care. “Linkage to ancillary services should be considered as one approach for improving patient outcomes among people living with HIV,” said Mr DeGroote. This can also “reduce HIV-related health disparities in the United States,” as concluded by the researchers.
- DeGroote NP, Korhonen LC, Shouse RL, Valleroy LA, Bradley H. Unmet needs for ancillary services among men who have sex with men and who are receiving HIV medical care – United States, 2013-2014. MMWR Morb Mortal Wkly Rep. 2016;65(37):1004-1007. doi: 10.15585/mmwr.mm6537a4.