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More than ancillary: HIV social services, intermediate outcomes and quality of life.

机译：不仅仅是辅助：艾滋病社会服务，中间结果和生活质量。

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In HIV care, the use of social or "ancillary" services to stabilize life situations and remove barriers to care is often seen as a means to the end of ensuring more consistent participation in medical care. By examining the impact of HIV social services on the achievement of intermediate outcomes (i.e., ceasing substance use, initiating anti-retroviral therapy (ART), and entering stable housing) and the relationship between intermediate outcome status and quality of life (QOL), our analysis aims to demonstrate the importance of achieving intermediate outcomes in and of themselves and thereby the importance of the ancillary services that assist clients in attaining desired intermediate outcomes. Our analysis relies on baseline and follow-up data from 1646 HIV-positive participants collected during a longitudinal outcome evaluation of 23 HIV social service programs in the New York metropolitan area. Multivariate linear regression modeling was used to assess the impact of achieving intermediate outcomes on QOL at follow-up, controlling for baseline QOL, and demographic factors. The greatest improvements in QOL were found in individuals who changed their intermediate outcome status from using drugs to not using, from not using ART to using ART, and from being unstably housed to being stably housed. Our analysis strongly suggests the importance of achieving intermediate outcomes in improving QOL, and thereby the importance of social services that facilitate the achievement of these intermediate outcomes. The analysis also provides further validation of a QOL measure, by showing that it varies in systematic and expected ways with the achievement of intermediate outcomes. Our study suggests that social services are not merely ancillary in HIV care but rather crucial for achieving both intermediate outcomes as well as the final outcome of improved QOL.
机译：在艾滋病毒护理中，使用社会或“辅助”服务来稳定生活状况和消除护理障碍通常被认为是确保更一致地参与医疗服务的一种手段。通过检查艾滋病毒社会服务对实现中间结果（即停止使用毒品，发起抗逆转录病毒疗法（ART）并进入稳定的住房）的影响以及中间结果状态与生活质量（QOL）之间的关系，我们的分析旨在证明自身以及实现中间结果的重要性，从而证明协助客户获得所需中间结果的辅助服务的重要性。我们的分析基于在纽约大都市地区对23个HIV社会服务项目进行纵向结果评估时收集的1646名HIV阳性参与者的基线和随访数据。多元线性回归模型用于评估随访时达到中间结果对生活质量的影响，控制基线生活质量和人口统计学因素。在将中间结果状态从使用毒品改为不使用，从不使用抗病毒药改为使用抗病毒药，以及从收容不稳改为收容后，个人的生活质量得到了最大的改善。我们的分析强烈表明，在改善生活质量方面达到中间结果的重要性，从而也有助于促进实现这些中间结果的社会服务的重要性。该分析还表明，随着实现中间结果，它以系统的和预期的方式发生变化，从而进一步验证了QOL措施。我们的研究表明，社会服务不仅是艾滋病毒护理的辅助手段，而且对于实现中间结果以及改善QOL的最终结果都至关重要。

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