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Background for the studies on ancillary services and primary care use.

机译:辅助服务和初级保健使用研究的背景。

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Timely and optimal HIV primary care is a key tenet of the Ryan White CARE Act, a safety net programme for vulnerable and marginalized people living with HIV in the USA. Health services researchers, local providers and policy makers suspect that ancillary services are necessary to improve entry into and retention in HIV primary care for vulnerable populations experiencing barriers to HIV services, including access to antiretroviral therapies. This paper provides background to the eight studies featured in this special supplement to AIDS Care. The eight studies examine retrospectively ancillary (support) services data collected after 1996 in six HIV epicenters (New York and Chicago, plus four sites included in the Client Demonstration project-Los Angeles, San Francisco, Orange County [California] and Washington, DC), three smaller hard-hit cities (Boston, New Orleans and St Louis) and several states (California, plus Michigan and Virginia from the Client Demonstration Projects). These varied delivery settings serve racial and ethnic minority populations, men who have sex with men, injection drug users, women and mothers. The studies use a range of analytic approaches to understand whether receipt of certain enabling services correlated with early entry into and retention in care. Ancillary services (support services such as case management, housing, food, transportation, mental health and substance abuse treatment) are used by local HIV medical and community-based organizations in facilitative strategies directed to populations that have difficulty entering or staying in HIV primary care. Understanding the contribution of ancillary services to timely entry into and consistent use of primary care, including the expanding range of HIV therapeutics, is important to service delivery system planners and resource allocation decision-makers.
机译:及时和最佳的艾滋病毒初级保健是《瑞安·怀特关怀法案》(Ryan White CARE Act)的一项主要宗旨,该法案是针对美国弱势和边缘化艾滋病毒感染者的安全网计划。卫生服务研究人员,当地医疗服务提供者和政策制定者怀疑,对于遭受艾滋病服务障碍(包括获得抗逆转录病毒疗法)的弱势人群,辅助服务对于提高进入和保留艾滋病毒初级保健的必要性。本文提供了此艾滋病护理专刊中的八项研究的背景。八项研究回顾了1996年后在六个HIV震中(纽约和芝加哥,以及客户示范项目中包括的四个地点-洛杉矶,旧金山,橙县[加利福尼亚]和华盛顿特区)收集的辅助(支持)服务数据。 ,三个较小的受灾较重的城市(波士顿,新奥尔良和圣路易斯)和几个州(加利福尼亚州,以及来自客户示范项目的密歇根州和弗吉尼亚州)。这些不同的分娩环境服务于种族和少数族裔人群,与男人发生性关系的男人,注射吸毒者,妇女和母亲。这些研究使用了一系列分析方法来了解某些扶持性服务的获得是否与早期进入和保留在护理中有关。地方艾滋病毒医疗和社区组织使用辅助服务(如案例管理,住房,食物,交通,心理健康和药物滥用治疗等支持服务),以针对难于进入或停留在艾滋病毒初级保健中的人群的便利策略。了解辅助服务对及时进入和持续使用初级保健的贡献,包括不断扩大的HIV治疗方法,对服务提供系统规划者和资源分配决策者至关重要。

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