Examining dynamics of care: Areas of concern, service satisfaction, and problem resolution among HIV+ women of color

Background: In 9/2009, the Health Resources and Services Administration, HIV/AIDS Bureau funded 10 programs to engage and retain HIV+ women of color (WoC) in care and a National Evaluation and Technical Assistance Center. The Center developed a standardized multi-site survey. Methods: Data come from 9/10 programs between 1/2010-12/2012. Part of a larger survey, the Dynamics of Care, administered 3-months post-baseline, allowed women to self-identify and prioritize areas of concern (AoCs) that could influence care seeking behaviors and health status. Prioritized AoC were followed to see if problems were being resolved/changed. Results: The 435 WoC were x=40.7 years (±11.42); African-American/Black (67.7%), Hispanic/Latina (22.8%); US-born (85.1%); no HS diploma (39.8%); unemployed (52.9%); no insurance (33.4%). WoC ranked the top 5 concerns into 3 dominant areas –life circumstances (44.5%), medical problems (23.1%), and psychological symptoms (12.4%). For 64.5%, the concern arose in the previous 6-months, with 6.9% reporting resolution and 7.4% reporting recurrence. Those who reported seeking professional help for the concern (58.2%) stated they were satisfied with the provider-based help received (97.3%). Asked to rate the services available, regardless of utilization or need, life circumstances received the lowest rating (42.6%). While medical problems and psychological symptoms were rated as 56.4% and 47.3%, respectively. Conclusion: Despite being top AoCs, life circumstances and psychological symptoms received the lowest service availability ratings. However, the majority where satisfied with the care they received to address the AoC but with low problem resolution. This calls into question the relationship between patient satisfaction, service availability, and problem resolution.