Targeted Needs Assessment
Pathways to Care
Ryan White Part A HIV/AIDS Program of the Las Vegas TGA
Grant Year 2014-2015
Shayla B. Streiff, MHA
Modern Consultants
Transforming Healthcare Data into Solutions
[email protected]
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Acknowledgements
This project was made possible by a grant from the U.S. Health Resources and Services
Administration HIV/AIDS Bureau under Part A of the HIV/AIDS Treatment Extension Act, with
support of the Ryan White Part A Planning Council and Clark County Social Services Ryan White
Part A HIV/AIDS Program. Additionally, thank you to the Ryan White Part A service providers and
consumers that participated in this project without whom this document would never have
been possible.
Service Area
The Las Vegas TGA is comprised of three counties–Clark and Nye Counties in Nevada, and
Mohave County, Arizona–covering a vast area of 39,368 square miles that crosses state borders.
As of December 31, 2014 there were a total of 8,528 persons living with HIV/AIDS (PLWH/A) in
Clark and Nye County alone as reported by the Nevada State Health Division-HIV/AIDS
Surveillance Program. They also reported that there were 4,398 persons living with AIDS (PLWA)
in Clark and Nye County and 4,130 people living with HIV (PLWH) in Clark and Nye County as of
December 31, 2014. The State of Arizona HIV/AIDS Surveillance Program listed the HIV/AIDS
prevalence for Mohave County as of December 31, 2013 at 264 people. This brings the total of
HIV/AIDS prevalence in the Las Vegas TGA to 8,792 as of December 31, 2014.
1
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Contents
Acknowledgements ........................................................ 1
Service Area .................................................................... 1
Contents ......................................................................... 2
Executive Summary ........................................................ 3
Introduction .................................................................... 5
Methodology .................................................................. 5
Epidemiological Data ...................................................... 6
Survey Results............................................................... 14
Newly Diagnosed .......................................................... 14
Demographics and Insurance Information ................... 14
HIV Testing and Diagnosis Questions ........................... 22
Recently Relocated ....................................................... 49
Demographics and Insurance Information ................... 49
Diagnosis and Services Questions................................. 58
Returned to Care .......................................................... 86
Demographics and Insurance Information ................... 86
Diagnosis and Services Questions................................. 95
Comparative Analysis ................................................. 117
Key Informant Interviews ........................................... 120
2
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Executive Summary
The Ryan White Planning Council of the Las Vegas TGA is entrusted each year with prioritizing
resources and allocating Ryan White dollars by service category, unrelated to who provides
these services, to help meet the needs of those living with HIV/AIDS. In order to effectively plan
for services and set funding priorities the Planning Council must base decisions on data provided
by this needs assessment and other related documents regarding service utilization, gaps in
care, barriers to care, and the needs and availability of services to PLWH/A.
This project was specifically designed to garner information from 1) Ryan White clients that have
been newly diagnosed with HIV in the last 18 months, 2) Ryan White clients that have moved to
the Las Vegas Area (including Mohave County, AZ, Nye County, NV, and Clark County, NV) on or
after July 1st, 2013 and are currently receiving HIV medical care, and 3) Ryan White clients that
have NOT received HIV medical care in the past for 6 months or more but are currently in care.
A list was derived from CAREWare reporting that pulled the contacting information for each of
these three groups of clients, the total list contained 949 names. Clients received a generic flyer
notifying them of the survey and providing them with call in information to participate. Trained
survey researchers then spent May and June of 2015 calling each client a minimum of three
times to solicit participation in their respective survey. The “Recently Relocated” group received
55 responses, the “Newly Diagnosed” with 89, and finally the “Returned to Care” with 61
respondents. All participants received a $10 Walmart gift card for their participation, with some
participants qualifying for more than one survey and consequently receiving an additional gift
card. All survey data was entered into the confidential web based program Survey Monkey for
analysis. The survey was also translated into Spanish and Spanish speaking survey researchers
were on hand to assist Spanish speaking clients.
After the results of the survey were analyzed, a key informant interview panel was outlined
targeting 28 individuals of which 20 participated. Specific questions were designed for each subpopulation of respondents based on their initial response, which included; “You rated the HIV
care in the Las Vegas Area as "Poor” or "Fair", what happened to make you feel this way?” and
“In your opinion, what can be done to better improve the services and what services need to be
improved?”. Again the same survey research team that was already trained in the project was
utilized to contact this sub-group of informants with bi-lingual staff on hand for Spanish
speaking clients.
Several questions regarding services and their importance were identical among the three
survey instruments so that the needs of each sub-population could be compared. When each
group was asked about the ONE service that helps them stay in care the top responses were;
1. HIV/AIDS medication
2. Case management/social worker
3. Eligibility services
4. Nurse case managers at the Southern Nevada Health District (primarily to newly
diagnosed and recently returned to care populations)
5. Mental health care
3
Ryan White Part A HIV/AIDS Targeted Needs Assessment
When asked about the important services that help to keep them healthy overall the top
choices were;
1. HIV/AIDS medication
2. Medical care
3. Case management
4. Eligibility services
5. Dental care
When asked about difficulty accessing services the top responses were;
1. Dental care
2. Mental health care
3. Medical transportation
4. Was a tie between
a. Emergency Financial Assistance
b. Medical care
c. Vision care
During key informant interviews, the recently relocated population was asked; 1. You rated the
HIV care in the Las Vegas Area as "Poor" or "Fair", what happened to make you feel this way? 2.
In your opinion, what can be done to better improve the services and what services need to be
improved?
As for question one, the majority of respondents stated that the system is inconvenient, too
much paperwork and too many agencies to go back and forth between, especially for those
clients that are employed. Difficulties scheduling appointments with doctors was also noted and
inconsistencies between agencies with regards to paperwork as well as not receiving the full
gamut of services that were discussed with them initially.
With regard to question two, clients suggested improvements such as; having a one stop shop
for services, limiting paperwork, more awareness of services, more support groups and food
banks located in a central region, and more community outreach.
The recently relocated population was also asked; 1. You rated the HIV care where you used to
live before moving to Las Vegas as "Excellent", what did they do there that made you feel it was
"Excellent"? 2. Do they do any of those things here when you receive care?
Respondents indicated the need for things such as; anal pap smears, a centrally located services
office, and more genuine care and follow-up.
The returned to care group was asked; 1. You reported that you were first diagnosed in an
Emergency Room/Hospital setting. After they told you about your diagnosis did they help you
get into HIV medical care, did a case manager meet with you and help you set up appointments
for HIV care while you were still in the hospital? 2. What hospital were you diagnosed at?
Unfortunately these participants weren’t directly linked with medical care at the time of
diagnosis but were provided with some information and medication.
4
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Introduction
The Ryan White Planning Council of the Las Vegas TGA is entrusted each year with prioritizing
resources and allocating Ryan White dollars by service category, unrelated to who provides
these services, to help meet the needs of those living with HIV/AIDS. In order to effectively plan
for services and set funding priorities the Planning Council must base decisions on data provided
by this needs assessment and other related documents regarding service utilization, gaps in
care, barriers to care, and the needs and availability of services to PLWH/A.
The intent of the 2015 Targeted HIV/AIDS Needs Assessment is to aid the council in collecting
data by identify service needs, gaps in care, barriers to care, and other important information
reported by people living with HIV/AIDS throughout the Las Vegas TGA. This project was
specifically designed to garner information from 1) Ryan White clients that have been newly
diagnosed with HIV in the last 18 months, 2) Ryan White clients that have moved to the Las
Vegas Area (including Mohave County, AZ, Nye County, NV, and Clark County, NV) on or after
July 1st, 2013 and are currently receiving HIV medical care, and 3) Ryan White clients that have
NOT received HIV medical care in the past for 6 months or more but are currently in care.
Methodology
This project contained a client survey in addition to key informant interviews to garner more
qualitative information regarding specific client responses to the survey. Three separate survey
instruments were designed and tailored to each target group addressing basic categories such
as; age, race, gender, sexual orientation, education, employment, housing, and transportation
circumstances. Each survey also addressed their pathway to care asking; where they tested
positive, how soon after testing did they enter care, if initially delayed care why, reasons for
testing, barriers to entering care (those specific to this TGA), and any reasons for a lapse in
medical care. Questions were also included surrounding service access and the service delivery
system, such as; what other support services would you like to see, what services are difficult to
access.
In order to contact these three very select groups of individuals CAREWare custom reporting
methods were used. Much of this was completed by searching key works in case notes, looking
at enrollment dates, and services timelines over the last five years. Each of the clients on these
lists, which totaled nine-hundred and forty-nine client’s total, was sent a generic letter outlining
the need for participation in a healthcare survey and provided them with call in information. It
also notified them that the survey team would be contacting them about participating in this
survey if they so desired. A team of trained survey researchers was established and each of the
nine-hundred and forty-nine individuals was contacted three times to ensure each person had a
sufficient opportunity to participate. Only clients with special circumstances such as, those
unable to participate by phone or the very ill were given the opportunity to participate via
online or on paper format. The “Recently Relocated” group received 55 responses, the “Newly
Diagnosed” with 89, and finally the “Returned to Care” with 61 respondents. All survey data was
entered into the confidential web based program Survey Monkey for analysis. The survey was
5
Ryan White Part A HIV/AIDS Targeted Needs Assessment
also translated into Spanish and Spanish speaking survey researchers were on hand to assist
Spanish speaking clients.
After the results of the survey were analyzed, a key informant interview panel was outlined
targeting 28 individuals of which 20 participated. Specific questions were designed for each subpopulation of respondents based on their initial response, which included; “You rated the HIV
care in the Las Vegas Area as "Poor” or "Fair", what happened to make you feel this way?” and
“In your opinion, what can be done to better improve the services and what services need to be
improved?”. Again the same survey research team that was already trained in the project was
utilized to contact this sub-group of informants with bi-lingual staff on hand for Spanish
speaking clients.
All participants received a $10 Walmart gift card through the mail for participating. Some
participants qualified for more than one survey, such as clients that recently relocated to the
TGA but were also newly diagnosed. Each separate survey and/or interview contribution was
compensated with an additional $10 Walmart gift card.
Epidemiological Data
In 2014 Clark and Nye County combined saw 375 new cases of HIV and 181 new cases of AIDS. In
2013 Mohave County saw 13 new cases of HIV/AIDS combined. New infections are primarily
found in the White, non-Hispanic (HIV 37% and AIDS 41%), Hispanic (HIV 30% and AIDS 25%),
and Black non-Hispanic (HIV 24% and AIDS 26%). Males are also infected at a much higher rate
than females representing 87% of new HIV infections and 83% of new AIDS infections.
Consequently the MSM population represented 75% of new HIV infections and 74% of new AIDS
cases in males.
Overall HIV/AIDS prevalence in Nevada is overwhelmingly located in Clark County at 86%. The
White non-Hispanic population represents 45% of HIV prevalence and 45% of AIDS prevalence in
Nevada. The Black non-Hispanic population represents 26% of HIV prevalence and 27% of AIDS
prevalence overall with the Hispanic population representing 23% of HIV prevalence and 23% of
AIDS prevalence. Again the MSM population represents 80% of HIV prevalence among males
and 77% of AIDS prevalence among males. Among the female population heterosexual contact
represents 64% of HIV prevalence and 61% of AIDS prevalence.
Mohave County statistics are very similar with the majority of new cases of HIV and AIDS in the
male population at 85%. The White, non-Hispanic population representing 67% of new HIV/AIDS
infections, Hispanic at 14% and Black, non-Hispanic at 3%. They have a much higher rate of
American Indian/Alaskan Native HIV/AIDS incidence at 9% compared to 1% in Clark County.
Incidence and prevalence data can be found in the charts below for Clark County, Nye County,
Mohave County, and the state of Nevada overall.
6
Ryan White Part A HIV/AIDS Targeted Needs Assessment
7
New HIV Infections and New AIDS Diagnoses in Nevada, 2014
Nevada State Health Division~ HIV/AIDS Surveillance Program
All Persons Living with HIV/AIDS
N
County of Residence
Clark County
8,446
Nye County
82
Washoe County
952
All Other
344
Counties**
Total
9,825
Sex at Birth
Male
8,276
Female
1,549
Total
9,825
Race/Ethnicity
White, non4,647
Hispanic
Black, non2,432
Hispanic
Hispanic
2,207
Asian/Hawaiian
/Pacific
330
Islander
American
Indian/Alaska
80
Native
Multi129
race/Other
Total
9,825
Age at End of Year
< 13
11
13 to 24
362
25 to 34
1,560
35 to 44
2,170
45 to 54
3,370
55 to 64
1,751
65 +
543
Missing
58
Total
9,825
Transmission Category
Males
Male-to-male
sexual contact
6,293
(MSM)
Injection Drug
497
Use (IDU)
MSM+IDU
639
Heterosexual
294
contact
Perinatal
33
Exposure
Transfusion/He
7
mophilia
NIR/NRR
513
Subtotal
8,276
Females
IDU
249
Heterosexual
936
contact
Perinatal
40
Exposure
Transfusion/He
3
mophilia
NIR/NRR
321
Subtotal
1,549
Total
9,825
Persons Living with HIV (not AIDS)
%
Rate*
n
%
Persons Living with AIDS
Rate*
n
%
Rate*
86%
1%
10%
411.6
182.6
217.6
4,098
32
432
87%
1%
9%
199.7
71.2
98.7
4,348
50
520
85%
1%
10%
211.9
111.3
118.8
4%
116.9
154
3%
52.3
190
4%
64.5
100%
347.3
4,717
100%
166.7
5,108
100%
180.6
84%
16%
100%
580.7
110.4
347.3
3,971
746
4,717
84%
16%
100%
278.6
53.1
166.7
4,305
803
5,108
84%
16%
100%
302.1
57.2
180.6
47%
304.4
2,236
47%
146.5
2,411
47%
157.9
25%
1,028.9
1,148
24%
485.7
1,284
25%
543.2
22%
280.7
1,053
22%
133.9
1,154
23%
146.8
3%
133.6
172
4%
69.6
158
3%
64.0
1%
246.2
37
1%
113.9
43
1%
132.4
1%
N/A
71
2%
N/A
58
1%
N/A
100%
347.3
4,717
100%
166.7
5,108
100%
180.6
0%
4%
16%
22%
34%
18%
6%
1%
100%
2.1
87.2
412.9
546.2
876.8
520.9
140.6
N/A
347.3
6
270
1,061
1,113
1,373
625
213
56
4,717
0%
6%
22%
24%
29%
13%
5%
1%
100%
1.1
65.1
280.9
280.2
357.2
185.9
55.2
N/A
166.7
5
92
499
1,057
1,997
1,126
330
2
5,108
0%
2%
10%
21%
39%
22%
6%
0%
100%
0.9
22.2
132.1
266.1
519.6
334.9
85.4
N/A
180.6
76%
N/A
3,096
78%
N/A
3,197
74%
N/A
6%
N/A
191
5%
N/A
306
7%
N/A
8%
4%
N/A
N/A
271
119
7%
3%
N/A
N/A
368
175
9%
4%
N/A
N/A
0%
N/A
11
0%
N/A
22
1%
N/A
0%
N/A
1
0%
N/A
6
0%
N/A
6%
100%
N/A
580.7
282
3,971
7%
100%
N/A
278.6
231
4,305
5%
100%
N/A
302.1
16%
60%
N/A
N/A
88
464
12%
62%
N/A
N/A
161
472
20%
59%
N/A
N/A
3%
N/A
14
2%
N/A
26
3%
N/A
0%
N/A
1
0%
N/A
2
0%
N/A
21%
100%
100%
N/A
110.4
347.3
179
746
4,717
24%
100%
100%
N/A
53.1
166.7
142
803
5,108
18%
100%
100%
N/A
57.2
180.6
Source: Nevada State Health Division HIV/AIDS Reporting System (eHARS), (March 2014)
Persons living with HIV/AIDS data include data on persons living in Nevada with HIV (not yet AIDS) and AIDS based on the current address listed in the HIV/AIDS Reporting System (eHARS). These persons may or may not have been diagnosed with
HIV or AIDS in Nevada.
* Rates per 100,000 population were calculated using 2014 population projections from the Nevada State Demographer vintage 2014 data.
**All other counties include Carson City, Churchill, Douglas, Elko, Esmeralda, Eureka, Humboldt, Lander, Lincoln, Lyon, Mineral, Pershing,Storey, & White Pine Counties.
Ryan White Part A HIV/AIDS Targeted Needs Assessment
8
New HIV Infections and New AIDS Diagnoses in Nevada, 2014
Nevada State Health Division~ HIV/AIDS Surveillance Program
All Persons Living with HIV/AIDS
N
County of Residence
Clark County
8,446
Nye County
82
Total
8,528
Sex at Birth
Male
7,178
Female
1,350
Total
8,528
Race/Ethnicity
White, non3,801
Hispanic
Black, non2,287
Hispanic
Hispanic
1,972
Asian/Hawai
ian/Pacific
297
Islander
American
Indian/Alask
58
a Native
Multi113
race/Other
Total
8,528
Age at End of Year
< 13
9
13 to 24
326
25 to 34
1,382
35 to 44
1,910
45 to 54
2,882
55 to 64
1,501
65 +
460
Missing
58
Total
8,528
Transmission Category
Males
Male-to5,597
male sexual
contact
(MSM)
Injection
393
Drug Use
(IDU)
MSM+IDU
519
Heterosexua
253
l contact
Perinatal
30
Exposure
Transfusion/
7
Hemophilia
NIR/NRR
379
Subtotal
7,178
Females
IDU
198
Heterosexua
845
l contact
Perinatal
34
Exposure
Transfusion/
1
Hemophilia
NIR/NRR
272
Subtotal
1,350
Total
8,528
%
Rate*
Persons Living with HIV (not AIDS)
Persons Living with AIDS
n
n
%
Rate*
%
Rate*
99%
1%
100%
411.6
173.4
406.2
4,098
32
4,130
99%
1%
100%
199.7
67.7
196.7
4,348
50
4,398
99%
1%
100%
211.9
105.7
209.5
84%
16%
100%
681.1
129.4
406.7
3,477
653
4,130
84%
16%
100%
329.9
62.6
197.0
3,701
697
4,398
84%
16%
100%
351.2
66.8
209.7
45%
374.6
1,842
45%
181.5
1,959
45%
193.1
27%
1,030.9
1,093
26%
492.7
1,194
27%
538.2
23%
311.2
950
23%
149.9
1,022
23%
161.3
3%
139.8
154
4%
72.5
143
3%
67.3
1%
406.3
26
1%
182.1
32
1%
224.2
1%
N/A
65
2%
N/A
48
1%
N/A
100%
406.7
4,130
100%
197.0
4,398
100%
209.7
0%
4%
16%
22%
34%
18%
5%
1%
100%
2.2
108.4
489.6
615.6
1,003.2
628.6
167.7
N/A
406.7
4
242
930
983
1,192
545
178
56
4,130
0%
6%
23%
24%
29%
13%
4%
1%
100%
1.0
80.5
329.5
316.8
414.9
228.2
64.9
N/A
197.0
5
84
452
927
1,690
956
282
2
4,398
0%
2%
10%
21%
38%
22%
6%
0%
100%
1.2
27.9
160.1
298.8
588.3
400.4
102.8
N/A
209.7
78%
N/A
2,765
80%
N/A
2,832
77%
N/A
5%
N/A
152
4%
N/A
241
7%
N/A
7%
4%
N/A
N/A
216
104
6%
3%
N/A
N/A
303
149
8%
4%
N/A
N/A
0%
N/A
9
0%
N/A
21
1%
N/A
0%
N/A
1
0%
N/A
6
0%
N/A
5%
100%
N/A
681.1
230
3,477
7%
100%
N/A
329.9
149
3,701
4%
100%
N/A
351.2
15%
63%
N/A
N/A
72
418
11%
64%
N/A
N/A
126
427
18%
61%
N/A
N/A
3%
N/A
11
2%
N/A
23
3%
N/A
0%
N/A
0
0%
N/A
1
0%
N/A
20%
100%
100%
N/A
129.4
406.7
152
654
4,130
23%
100%
100%
N/A
62.7
197.0
120
697
4,398
17%
100%
100%
N/A
66.8
209.7
Source: Nevada State Health Division HIV/AIDS Reporting System (eHARS), (March 2014)
Persons living with HIV/AIDS data include data on persons living in Nevada with HIV (not yet AIDS) and AIDS based on the current address listed in the HIV/AIDS Reporting System (eHARS). These persons may or
may not have been diagnosed with HIV or AIDS in Nevada.
* Rates per 100,000 population were calculated using 2014 population projections from the Nevada State Demographer vintage 2014 data.
Ryan White Part A HIV/AIDS Targeted Needs Assessment
9
New HIV Infections and New AIDS Diagnoses in Nevada, 2014
Nevada State Health Division~ HIV/AIDS Surveillance Program
New HIV Infections
N
County of Diagnosis
Clark + Nye
375
County
Washoe County
37
All Other
8
Counties**
Total
420
Sex at Birth
Male
364
Female
56
Total
420
Race/Ethnicity
White, non155
Hispanic
Black, non101
Hispanic
Hispanic
128
Asian/Hawaiian/
23
Pacific Islander
American
Indian/Alaska
3
Native
Multi10
race/Other
Total
420
Age at Diagnosis
< 13
2
13 to 24
97
25 to 34
145
35 to 44
78
45 to 54
73
55 to 64
22
65 +
3
Total
420
Transmission Category
Males
Male-to-male
273
sexual contact
(MSM)
Injection Drug
12
Use (IDU)
MSM+IDU
25
Heterosexual
11
contact
Perinatal
0
Exposure
Transfusion/He
0
mophilia
NIR/NRR
43
Subtotal
364
Females
IDU
5
Heterosexual
20
contact
New AIDS Diagnoses
%
Rate*
N
%
Rate*
89%
17.9
181
88%
8.6
9%
8.5
19
9%
4.3
2%
2.7
6
3%
2.0
100%
14.8
206
100%
7.3
87%
13%
100%
25.5
4.0
14.8
170
36
206
83%
17%
100%
11.9
2.6
7.3
37%
10.2
84
41%
5.5
24%
42.7
54
26%
22.8
30%
16.3
51
25%
6.5
5%
9.3
15
7%
6.1
1%
9.2
2
1%
6.2
2%
N/A
0
0%
N/A
100%
14.8
206
100%
7.3
0%
23%
35%
19%
17%
5%
1%
100%
0.4
23.4
38.4
19.6
19.0
6.5
0.8
14.8
0
17
50
54
58
22
5
206
0%
8%
24%
26%
28%
11%
2%
100%
0.0
4.1
13.2
13.6
15.1
6.5
1.3
7.3
75%
N/A
126
74%
N/A
3%
N/A
8
5%
N/A
7%
3%
N/A
N/A
13
3
8%
2%
N/A
N/A
0%
N/A
0
0%
N/A
0%
N/A
0
0%
N/A
12%
100%
N/A
25.5
20
170
12%
100%
N/A
11.9
9%
36%
N/A
N/A
4
15
11%
42%
N/A
N/A
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Perinatal
Exposure
Transfusion/He
mophilia
NIR/NRR
Subtotal
Total
10
2
4%
N/A
0
0%
N/A
0
0%
N/A
0
0%
N/A
29
56
420
52%
100%
100%
N/A
4.0
14.8
17
36
206
47%
100%
100%
N/A
2.6
7.3
Source: Nevada State Health Division HIV/AIDS Reporting System (eHARS), (March 2014)
New HIV Infections are counted in eHARS surveillance statistics and include HIV and AIDS cases diagnosed in Nevada, both living and deceased. The surveillance data
exclude HIV/AIDS cases diagnosed in other states, but who currently live in Nevada. HIV Diagnoses and AIDS Diagnoses may duplicate case counts if the person was
diagnosed with both HIV and AIDS in 2014.
* Rates per 100,000 population were calculated using 2014 population projections from the Nevada State Demographer vintage 2014 data.
**All other counties include Carson City, Churchill, Douglas, Elko, Esmeralda, Eureka, Humboldt, Lander, Lincoln, Lyon, Mineral, Pershing,Storey, & White Pine Counties.
New HIV Infections and New AIDS Diagnoses in Nevada, 2014
Nevada State Health Division~ HIV/AIDS Surveillance Program
New HIV Infections
N
Sex at Birth
Male
325
Female
50
Total
375
Race/Ethnicity
White, non119
Hispanic
Black, non100
Hispanic
Hispanic
120
Asian/Hawaiian/
23
Pacific Islander
American
Indian/Alaska
3
Native
Multi10
race/Other
Total
375
Age at Diagnosis
< 13
0
13 to 24
89
25 to 34
130
35 to 44
71
45 to 54
62
55 to 64
20
65 +
3
Total
375
Transmission Category
Males
Male-to-male
255
sexual contact
(MSM)
Injection Drug
6
Use (IDU)
MSM+IDU
18
Heterosexual
11
contact
Perinatal
0
Exposure
New AIDS Diagnoses
%
Rate*
87%
13%
100%
30.8
4.8
17.9
148
33
181
82%
18%
100%
14.0
3.2
8.6
32%
11.7
66
36%
6.5
27%
45.1
51
28%
23.0
32%
18.9
47
26%
7.4
6%
10.8
15
8%
7.1
1%
21.0
2
1%
14.0
3%
N/A
0
0%
N/A
100%
17.9
181
100%
8.6
0%
24%
35%
19%
17%
5%
1%
100%
0.0
29.6
46.1
22.9
21.6
8.4
1.1
17.9
0
17
46
48
46
20
4
181
0%
9%
25%
27%
25%
11%
2%
100%
0.0
5.7
16.3
15.5
16.0
8.4
1.5
8.6
78%
N/A
121
82%
N/A
2%
N/A
1
1%
N/A
6%
3%
N/A
N/A
10
3
7%
2%
N/A
N/A
0%
N/A
0
0%
N/A
N
%
Rate*
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Transfusion/He
mophilia
NIR/NRR
Subtotal
Females
IDU
Heterosexual
contact
Perinatal
Exposure
Transfusion/He
mophilia
NIR/NRR
Subtotal
Total
0
0%
N/A
0
0%
N/A
35
325
11%
100%
N/A
30.8
13
148
9%
100%
N/A
14.0
3
19
6%
38%
N/A
N/A
4
14
12%
42%
N/A
N/A
1
2%
N/A
0
0%
N/A
0
0%
N/A
0
0%
N/A
27
50
375
54%
100%
100%
N/A
4.8
17.9
15
33
181
45%
100%
100%
N/A
3.2
8.6
11
Source: Nevada State Health Division HIV/AIDS Reporting System (eHARS), (March 2014)
New HIV Infections are counted in eHARS surveillance statistics and include HIV and AIDS cases diagnosed in Nevada, both living and deceased. The surveillance data
exclude HIV/AIDS cases diagnosed in other states, but who currently live in Nevada. HIV Diagnoses and AIDS Diagnoses may duplicate case counts if the person was
diagnosed with both HIV and AIDS in 2014.
* Rates per 100,000 population were calculated using 2014 population projections from the Nevada State Demographer vintage 2014 data.
Ryan White Part A HIV/AIDS Targeted Needs Assessment
12
Ryan White Part A HIV/AIDS Targeted Needs Assessment
13
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Survey Results
Newly Diagnosed
This survey instrument was specific to Ryan White clients that have been newly diagnosed with
HIV within the last 18 months.
Demographics and Insurance Information
The majority of respondents indicated they were FIRST diagnosed with HIV 1 to 3 months ago,
followed by 4 to 6
months and 10 to
12 months. This
newly diagnosed
demographic will
provide us with an
insight into recent
service delivery
processes and
issues that may
need to be
addressed to
improve the
system of care.
14
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
HISPANIC
IRISH
LATINO
MULATTO
ITALIAN ARABIAN
15
Ryan White Part A HIV/AIDS Targeted Needs Assessment
16
Ryan White Part A HIV/AIDS Targeted Needs Assessment
17
Ryan White Part A HIV/AIDS Targeted Needs Assessment
18
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
FIGHTING
GETTING A TATTOO
TRANSGENDER AND MALE
NOT SURE IF BETWEEN MALE TO MALE OR HETEROSEXUAL SEXUAL CONTACT
19
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
RYAN-WHITE PARTS A AND C
RYAN WHITE A B C D
RYAN-WHITE PROGRAM
PENDING MEDICAID
AMERIGROUP
MEDICARE PART C; ARIZONA ACCESS
RYAN-WHITE PROGRAM
RYAN-WHITE PROGRAM (PART D)
RYAN-WHITE PROGRAM
RYAN-WHITE IS THE ONLY HELP I RECEIVE
RYAN-WHITE IS THE ONLY HELP I RECEIVE
JUST THE RYAN-WHITE
RYAN-WHITE IS THE ONLY HELP I RECEIVE
RYAN-WHITE IS THE ONLY HELP I RECEIVE
RYAN-WHITE
OBAMACARE
20
Ryan White Part A HIV/AIDS Targeted Needs Assessment
21
Ryan White Part A HIV/AIDS Targeted Needs Assessment
HIV Testing and Diagnosis Questions
The majority of respondents initially tested HIV positive in the Las Vegas area. As we know Ryan
White funding does not follow the individual when they move and Ryan White funding is based
upon prevalence.
Knowing where to get tested is often an issue, especially free testing where the individual feels
comfortable. Many of the respondents found out where to get tested from friends/word-ofmouth, the health district, their doctor’s office and the LGBT community center. Most actually
tested positive at the health district with an alarming 15 people that tested positive in a hospital
or emergency room setting.
22
Ryan White Part A HIV/AIDS Targeted Needs Assessment
23
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
AFAN COMMUNITY COUNSELING CENTER
PAIUTE HEALTH FACILITY
AHF TESTING VAN
VAN
AHF
NORTH COUNTRY CLINIC
The majority of respondents indicated they tested positive as part of a routine check-up with 29
stating they had unprotected sex with someone who might have been HIV positive and another
29 stating they felt like they should be tested with 17 that said they felt sick.
Other (please specify)
THEY GAVE ME AS A CONTACT AT THE HEALTH DISTRICT FOR SOMEONE WHO TESTED
POSITIVE FOR HIV
I WANTED TO GET TESTED FOR EVERYTHING TO SEE IF I WAS CLEAN OR NOT
PLAYING A MONEY GAME, HAD TO GET TESTED TO WIN
COLLAPSE DOCTORS CHECKED BLOOD
WAS GETTING SURGERY (HOSPITAL)
24
Ryan White Part A HIV/AIDS Targeted Needs Assessment
AUTOMATIC TESTING AT OUTREACH CLINIC
PRIVATE COMPANY RECOMMENDED IT--THROUGH PLASMA DONATION
RECEIVED A CALL DIRECTLY FROM A PREVIOUS PARTNER TELLING ME TO GET TESTED
MY PARTNER HAD TESTED POSITIVE AND SO I GOT TESTED AS WELL
ROUTINE TEST
AT THE PLASMA DONATION THEY TOLD ME TO GO GET TESTED AT PLANNED
PARENTHOOD
I ENCOURAGE YOUNGER PEOPLE TO GET TESTED SO I LED BY EXAMPLE AND GOT
TESTED MYSELF.
I WAS GETTING A PHYSICAL
PAST PARTNER HAD TAKEN OFF PROTECTION DURING INTERCOURSE
HAD HEALTH PROBLEMS, BEEN IN AND OUT OF HOSPITAL TOO MANY TIMES SO I
WANTED TO GET TESTED
HAD ISSUES WITH MY THYROID AND DIAGNOSIS CAME OUT IN LAB RESULTS
I MOTIVATED MYSELF
RECOMMENDATION OF THE HEALTH DISTRICT
UNDER THE INFLUENCE OF METHAMPHETAMINE
POSITIVE RESULT CAME OUT IN BLOOD WORK DONE FOR THE HOSPITAL
I WANTED TO CONFIRM THE TESTING KIT RESULT
RECOMMENDATION OF THE HEALTH DISTRICT
WENT TO GET HEPATITIS B VACCINATION AND THEY TOLD ME TO GET IT DONE
All of thre respondents were linked into medical care immediately with the exception of one
individual that tested positive outside of the U.S. and was unable to immediately access care.
25
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
SOCIAL WORKER REFERRED ME W/ HIV MEDICAL CARE
MY GENERAL DOCTOR GAVE ME A LIST OF DOCTORS AND I CHOSE MY DOCTOR
TOLD HIM TO SEE A DOCTOR
WENT TO REGULAR PHYSICIAN TO GET CARE
HOPE PROGRAM IN RENO SIGNED ME UP FOR SERVICES IN THE AREA
THE FIRST THREE OPTIONS
THE FIRST THREE OPTIONS
I WAS TRYING TO GET MEDICAL CARE IN SERBIA BUT THEY DIDN'T HAVE TREATMENT FOR MY
VIRAL COUNT BECAUSE IT WAS TOO LOW.
AIDS HEALTHCARE FOUNDATION HAVE GUIDED ME THROUGH EVERYTHING.
A CONTACT PERSON CALLED ME TO SET UP AN APPOINTMENT WITH AIDS HEALTHCARE
FOUNDATION
APPOINTMENT SCHEDULED FOR ME WITH THE UMC WELLNESS CENTER
THE HOSPITAL GAVE ME $800 WORTH OF MEDICINE
APPOINTMENT WITH THE HEALTH DISTRICT
I WAS SEEN BY DOCTOR FOR INFECTION CONTROL IN THE HOSPITAL
AN APPOINTMENT WAS MADE FOR ME FOR THE WELLNESS CENTER NEAR UMC
APPOINTMENT WAS MADE FOR ME FOR THE ACCESS HEALTHCARE CENTER
HEALTH DEPARTMENT WORKER SPOKE WITH ME
WAS REFERRED BY PRIMARY CARE DOCTOR TO A SPECIALIST
BLOOD WORK WAS DONE AND APPOINTMENT WITH HEALTH DISTRICT WAS MADE FOR ME
HEALTH DISTRICT HELPED ME AND REFERRED ME TO A DOCTOR, SHE WAS GREAT.
I WAS MADE AN APPOINTMENT AT THE PLACE NEXT TO UMC (HAS IT'S OWN PHARMACY)
I WAS ASKED WHO I HAD BEEN WITH, I GAVE THE INFORMATION, WAS GIVEN A LIST OF
DOCTORS, AND THEN I LOOKED UP WHERE TO GO BY MYSELF.
I INFORMED MYSELF AND FRIENDS REFERRED ME TO RYAN-WHITE
BARBARA AT HEALTH DISTRICT GOT ME 3 MONTHS OF MEDICATION FOR FREE AND
REFERRED ME TO OTHER SOURCES
I WAS SENT TO RYAN-WHITE
NURSE IN THE HEALTH DISTRICT TOLD ME TO APPLY FOR RYAN-WHITE BECAUSE I HAD NO
INCOME OR INSURANCE
ALL OF THE FIRST THREE OPTIONS ABOVE
REFERRAL FROM MY DOCTOR
REFERRAL FROM PRIMARY PHYSICIAN
THEY SET ME UP WITH RYAN-WHITE PART B
26
Ryan White Part A HIV/AIDS Targeted Needs Assessment
The vast majority of clients accessed care within the first 15 days and nearly all within the first
30 days after diagnosis. When asked about their motivations for seeking care so quickly the
majority indicated they were concerned about their health, they were afraid of dying, or they
were extremely ill and knew they needed medical attention. The overarching themes are
outlined in the table below with the actual text of answers following.
27
Ryan White Part A HIV/AIDS Targeted Needs Assessment
28
You stated you saw a doctor for your HIV status within 90 days of diagnosis, what motivated you
to seek care?
SO I COULD TAKE CARE OF IT AND KEEP IT UNDER CONTROL.
WANTED TO BE SURE / KEEP MYSELF HEALTHY
MY SOCIAL WORKER TOLD ME IT WAS BEST TO SEEK TREATMENT. I HAD NO SYMPTOMS (OTHER
THAN LOST WEIGHT)
I HAVE FRIENDS THAT HAVE HIV AND I KNOW WHAT THEY'VE GONE THROUGH AND I WAS REALLY
EMOTIONAL. I WAS DEPRESSED BUT I DECIDED I WOULDN'T SIT HERE AND DIE. I HAD ALREADY
LOST MY MOM.
TO MAKE SURE THAT HE IS HEALTHY
BECAUSE HE WAS SICK
THE HEALTH DEPARTMENT TOLD HIM TO SEE DOCTOR
KNOWING IT WAS FATAL WITH NO CARE
STAY HEALTHY
HAD HIV WANTED TO TAKE CARE OF MYSELF
I JUST WANTED TO HELP MYSELF. I'M 20 YEARS OLD AND MY LIFE'S BARELY STARTED.
IT WAS SOMETHING THAT I NEEDED TO TAKE CARE OF.
I WAS SCARED, I DIDN'T KNOW WHAT WAS GOING ON.
SO I COULD KEEP MY LEVELS WHERE THEY ARE SUPPOSED TO BE.
NOT DYING, BUT MAINLY I WANTED TO PROTECT MYSELF AND MY PARTNER (HE'S HIV-NEGATIVE).
I WANT TO TAKE CARE OF MYSELF.
THE SYMPTOMS AND THE FACT THAT I HAD A SORE THROAT. I FELT SOMETHING WAS DEFINITELY
WRONG.
WANTED TO STAY HEALTHY
SOCIAL WORKER/ WANTING TO LIVE
LOSING TOO MUCH WEIGHT/ HAIR LOSS/ SIZE 14 TO 3
THE DIAGNOSIS
DECIDED TO TAKE GOOD CARE OF HIMSELF
THE FIRST DOCTOR THAT SAW ME REFERRED ME TO THE SECOND DOCTOR I SAW, A SPECIALIST.
CHECK UP
I WANTED TO GET IT UNDER CONTROL.
Ryan White Part A HIV/AIDS Targeted Needs Assessment
29
BECAUSE I WANT TO BE HEALTHY.
BETTER HEALTH
MY HEALTH, I WANT TO LIVE.
MY OWN HEALTH.
IF I DIDN'T SEE A DOCTOR I WOULD DIE.
MY HEALTH.
I HAD PHYSICAL CONCERN AND FOR MY HEALTH.
IT WAS PEOPLE TOLD ME I NEEDED TO DO, TO CONTINUE SEEING A DOCTOR SO I COULD
CONTINUE MY MEDICATION.
I WANTED TO KNOW HOW TO GO ABOUT MY DIAGNOSIS AND TAKE CARE OF MYSELF WITH
TREATMENT. I'M STILL WAITING FOR A CURE.
DON'T WANT TO DIE
MAKE SURE TO STAY HEALTHY
BECAUSE OF MY BABY.
BECAUSE I DIDN'T WANT TO DIE.
THE DIAGNOSIS.
I'M A HEALTHY INDIVIDUAL AND I JUST REALLY WANT TO STAY ON TOP OF MY HEALTH. I WANT
TO INCREASE MY CHANCES OF LONGEVITY AND HAVE A LONG AND HEALTHY LIFE.
I HAD MADE AN APPOINTMENT FOR MYSELF.
TO GET MEDICATION.
FAMILY SUPPORT, GOALS THAT I HAD FOR MYSELF, AND THE PEOPLE AT THE CLINIC HELPED ME.
TREATMENT
FAMILY
TO STAY ALIVE.
I WAS NOT FEELING WELL AT ALL.
TO STAY WELL.
I FELT SICK AND I WANTED TO VERIFY THAT I HAD THE VIRUS. I WANTED TO KNOW MY DIAGNOSIS
FOR SURE.
TO LIVE.
I HAVE A BROKEN BACK THAT I WAS TRYING TO GET REPAIRED BUT THE BYPASS SURGERY WAS TO
GET MY HEART IN SHAPE FOR THE BACK SURGERY BUT BLOOD WORK DONE FOR THE BYPASS
SURGERY SHOWED POSITIVE FOR HIV.
I DIDN'T WANT THE DISEASE TO PROGRESS ANY MORE. I WANTED TO GET MEDICATION TO
BECOME UNDETECTABLE AS QUICKLY AS POSSIBLE.
I DIDN'T WANT TO GET SICKER AND DIE AND LEAVE MY FAMILY ALONE. MY FAMILY IS IMPORTANT
TO ME.
TO LOOK FOR TREATMENT.
FOR MY HEALTH AND TO BE INFORMED ABOUT MY HEALTH. TO KNOW HOW TO CARE FOR
MYSELF TO NOT INFECT THOSE THAT LIVE WITH ME.
MYSELF, BECAUSE I WANT TO KEEP LIVING.
LIFE.
MY HEALTH ISSUES. MY PARTNER AND I WANT TO GET HEALTHY AGAIN. WE WANT TO MAKE SURE
WE'RE OKAY WITH MEDICINE AND OTHER THINGS.
BECAUSE IT WAS IN MY BEST INTEREST TO DO THAT.
MY HEALTH.
LIFE.
TO KEEP LIVING AND HAVE A GOOD QUALITY OF LIFE.
IT WAS FOR MY HEALTH.
Ryan White Part A HIV/AIDS Targeted Needs Assessment
ONCE I FOUND OUT I WAS INFECTED THERE WAS NO POINT TO GET ANGRY, I STARTED
TREATMENT TO MAKE SURE I WAS HEALTHY AND TO STAY HEALTHY.
THEY TOLD ME THAT I HAD TO BE IN TREATMENT.
WORRIED ABOUT HEALTH
MY CHOICE TO LIVE. MY ULTIMATE GOAL IS TO BE HEALTHY AND UNDETECTABLE.
THE DOCTOR HAD TOLD ME I WAS POSITIVE AND IT HAD RECENTLY HAPPENED.
BECAUSE I HAVE A BABY SISTER AND I REALLY LOVE HER, SHE'S LIKE MY DAUGHTER, SO I SAID I
NEED TO BE HEALTHY FOR HER.
TO STAY HEALTHY.
JUST MY AGE.
I ALREADY KNEW THE SOONER I STARTED GETTING TREATMENT THE BETTER IT WAS FOR ME.
ALSO, THE COUNSELOR AT THE GAY AND LESBIAN CENTER ENCOURAGED ME.
I HAD HEALTH ISSUES THAT I NEEDED TO CARE OF.
JUST BECAUSE I DIDN'T WANT TO GET SICK OR GET TO A LEVEL WHERE I CAN'T REVERSE MY
STATUS.
TO TAKE CARE OF MYSELF, SELF-MOTIVATION
MY OWN WELL-BEING
WANTED TO GET TREATED.
Just five people indicated that they waited more than 90 days after diagnosis to see a doctor for
their HIV status. The biggest reasons being fear and denial.
The “other” responses are listed in the table below.
Other
SCHEDULING ISSUES
IT JUST FELT LIKE A DEATH SENTENCE
NO HEALTH INSURANCE
30
Ryan White Part A HIV/AIDS Targeted Needs Assessment
31
Ryan White Part A HIV/AIDS Targeted Needs Assessment
When asked about motivators for getting into care the vast majority stated that they felt ready,
followed by encouragement from friends/family/partners and case managers/social
workers/nurses followed by linkage to care coordination and religious beliefs.
32
Ryan White Part A HIV/AIDS Targeted Needs Assessment
The “other” responses are listed in the table below. Most reasons reflect self-motivation and
motivation from doctors and other health care workers.
Other (please specify)
MY PRIVATE DOCTOR
RYAN WHITE PROGRAM
DOCTOR TOLD ME TO
I HAD GOTTEN A NEW JOB
33
Ryan White Part A HIV/AIDS Targeted Needs Assessment
THE DOCTOR THAT TREATED ME WHEN I FIRST STARTED FEELING SICK; SOUTHERN NEVADA
HEALTH DISTRICT COUNSELOR (BETH); I MOTIVATED MYSELF
MYSELF
DOCTOR MADE APPOINTMENT AT EMERGENCY
NONE OF THESE--JUST MYSELF.
MYSELF
I WANTED TO START TREATMENT BECAUSE OF MY PREGNANCY.
SOMEONE FROM THE HEALTH DEPARTMENT
RYAN-WHITE PROGRAM
MY OWN DETERMINATION
DOCTORS AT THE HOSPITAL ENCOURAGED ME; I STARTED MEDICATION BY THE TIME I LEFT
THE HOSPITAL
IT WAS SOMETHING I HAD TO DO.
MY MEDICATION
MY OB-GYN DOCTOR ENCOURAGED ME
I MOTIVATED MYSELF.
MOTIVATED MYSELF DUE TO THE SITUATION
I JUST FELT LIKE SOMETHING WAS WRONG
I MOTIVATED MYSELF.
MY OWN WELL-BEING
JUST WANTED IMMEDIATE HELP
THE DOCTOR TOLD ME THAT I HAD HIV IN MY BLOOD.
WAS REFERRED TO A DOCTOR RECOMMENDED BY EVERYONE I KNEW
AHM HEALTH CARE PROGRAM
MY OWN WELL-BEING
When clients were asked about the first three services they accessed when entering the HIV
care system the top five most selected were;
1.
2.
3.
4.
5.
HIV medical care/doctor/clinic
HIV/AIDS medication
Case management/social workers
Nurse case managers at the SNHD
Food bank/food vouchers
“Other” was also highly selected at 42% with most comments surrounding blood work and
counseling or Ryan White services. All comments can be seen in the table below.
34
Ryan White Part A HIV/AIDS Targeted Needs Assessment
When you first entered the HIV care system, what were the FIRST THREE services
that you accessed? (select three only)
Answer Options
HIV medical care/doctor/clinic
HIV/AIDS medication
Other (please specify)
Case management/Social Worker
Nurse case managers at the Southern Nevada Health
District
Food bank/food vouchers
Dental care
Mental health care
Medical Transportation (bus passes)
Don't know
Eligibility services
Medical nutrition therapy (meeting with a dietitian)
Housing assistance (short term assistance with
housing or referrals for available housing)
Assistance with health insurance co-payments and
premiums
Health education/risk reduction classes (Health
Relationships or Mothers, Sisters, Daughters)
Substance abuse treatment
Emergency financial assistance (with utilities and
housing)
Child care services
Legal services (such as living will)
Language interpretation services
Support groups
Nurse navigators
Prefer not to answer
Response
Percent
Response
Count
74.1%
48.2%
42.4%
37.6%
63
41
36
32
15.3%
13
14.1%
7.1%
4.7%
4.7%
4.7%
3.5%
2.4%
12
6
4
4
4
3
2
2.4%
2
1.2%
1
1.2%
1
0.0%
0
0.0%
0
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0
0
0
0
0
0
answered question
skipped question
Other (please specify)
AHF
AHF
ASSISTANCE WITH PRESCRIPTION PAYMENT (BRISTOL-MEYERS)
BLOOD WORK DONE
BLOOD WORK DONE AT THE HEALTH DISTRICT
BLOOD WORK WAS DONE
BLOOD WORK WAS DONE
COUNSELING
COUNSELING
85
4
35
Ryan White Part A HIV/AIDS Targeted Needs Assessment
HEALTH DEPARTMENT CALLED ME
I HAVEN'T USED ANY HEALTH CARE SERVICES YET
LABS WERE DONE; MET WITH A RYAN-WHITE CASE MANAGER
LGBT CENTER TESTING
MEDICAID
MEDICAID
MEDICAL TESTS
MEDICAL TESTS
MEDICATION FOR SYPHILIS
MY PRIVATE DOCTOR REFERRED ME TO SPECIALIST
NOT YET, BECAUSE A LOT OF DOCUMENTATION GOES INTO THE PROCESS BEFORE BEING
ABLE TO ACCESS ALL THESE SERVICES
RED, WHITE AND BLUE & AFAN
REFERRED UMC WELLNESS CENTER
RIGHT NOW I'M JUST GOING TO THE UMC WELLNESS CENTER
RYAN-WHITE ACCESS-ASSISTANCE WITH MEDICATION
RYAN-WHITE PART B PROGRAM
RYAN-WHITE PROGRAM
RYAN-WHITE PROGRAM
RYAN-WHITE PROGRAM
RYAN-WHITE PROGRAM; BLOOD WORK WAS DONE
RYAN-WHITE PROGRAMS A & B; TEMPORARY HEALTH ASSISTANCE FROM THE HEALTH
DEPARTMENT
SAW DOCTORS AT UMC
SOUTHERN NEVADA HEALTH DISTRICT; I SIGNED UP FOR THERAPY
ST. TERESA FOOD DISTRIBUTION/PANTRY
TESTING AND COUNSELING
TESTING AND COUNSELING
UMC TO GET TESTED (INCOMPETENT/MESSED UP RESULTS TWICE)
When asked about the one service that helped them see an HIV doctor for the first time the
majority stated a case manager or social worker followed by the nurse case managers at the
SNHD.
36
Ryan White Part A HIV/AIDS Targeted Needs Assessment
37
Ryan White Part A HIV/AIDS Targeted Needs Assessment
The “other” comments are listed in the table below. The majority indicate private doctor or selfmotivation.
Other (please specify)
A VISIT TO MY UMC PRIMARY DOCTOR, WHO REFERRED ME TO THE INFECTIOUS DISEASE
CONSULTANT
AFAN
ASSISTANCE PAYING FOR MY MEDICATIONS
BLOOD WORK DONE WITH THE HEALTH DISTRICT
COUNSELING--BETH MY COUNSELOR THROUGH THE SOUTHERN NEVADA HEALTH
DISTRICT
DOCTOR THAT SET UP HIV CARE APPOINTMENT
DOCTORS AT THE HOSPITAL
ELIGIBILITY SERVICES/MEDICAID
EMERGENCY ROOM DOCTOR
HEALTH DEPARTMENT TOLD ME TO SEE AN HIV DOCTOR
HEART SPECIALIST--PUT ME IN CARE OF THE PHYSICIAN (INFECTION CONTROL SPECIALIST)
HIV TESTING AT THE COMMUNITY HEALTH CLINIC
HOPE CLINIC IN RENO
HOSPITAL VISIT FOR HEART ATTACK
I MADE MYSELF AN APPOINTMENT
I MOTIVATED MYSELF
INITIAL COUNSELING
INITIAL COUNSELING
JUST MYSELF-I WAS THE ONE TO LOOK FOR A DOCTOR AND SERVICES.
JUST MYSELF--I WAS THE ONE TO LOOK FOR A DOCTOR THROUGH MY INSURANCE
MOBILE TESTING SITE PEOPLE
MY GENERAL DOCTOR
MY GENERAL DOCTOR
MY PRIVATE DOCTOR
MY REGULAR DOCTOR I WENT TO SEE FOR A CHECK-UP
NONE OF THESE
NURSE FROM UMC
PROVIDER BOOKLET
REFERRAL FROM MY REGULAR DOCTOR
THE CONTACT PERSON AT THE AIDS HEALTHCARE FOUNDATION
THE DOCTORS AT THE HEALTH DISTRICT
THE HOSPITAL
WELLNESS CENTER
38
Ryan White Part A HIV/AIDS Targeted Needs Assessment
When provided with the same list clients said the one service that helps keep them in medical
care is HIV/AIDS medication followed by case managers and social workers.
The “other” comments include their personal interest in staying healthy and a specific doctor
they see among other organizations. All comments can be seen in the chart below.
39
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
AFAN
AHF ASSOCIATES
ASSISTANCE PAYING FOR MY MEDICATIONS AND DOCTOR VISITS
BETH, MY COUNSELOR AT THE SOUTHERN NEVADA HEALTH DISTRICT
CASE MANAGER/HIV MEDICATION
COUSELOR
DOCTOR QUALITY CARE
ELIGIBILITY SERVICES/MEDICAID
FOR MEDICAL CARE IN GENERAL
HAVEN'T BEEN TO THE DOCTOR, HIS APPOINTMENT IS 5/26
HEALTH
I HAVEN'T BEEN BACK TO THE SPECIALIST BECAUSE MY RESULTS WERE MESSED UP BY UMC
AND I NEEDED THOSE SO THE DOCTOR COULD PRESCRIBE MEDICATIONS FOR ME.
I HAVEN'T SEEN A SPECIALIST, I HAVEN'T BEEN SCHEDULED
I JUST DO IT ON MY OWN.
I MOTIVATE MYSELF TO MAKE SURE I TAKE CARE OF MY HEALTH, FOR MY KIDS.
I MOTIVATE MYSELF TO MAKE SURE I TAKE CARE OF MY HEALTH.
I'M ENCOURAGING MYSELF
MEDICATION/DOCTOR--I REALLY LIKE MY DOCTOR
MEDICATION/DOCTORS/ EVERYTHING HELPS KEEP ME GOING
MY DOCTOR AT THE MILITARY BASE
MY INTEREST IN STAYING HEALTHY.
NONE OF THESE--JUST MYSELF
OUTREACH COMMUNITY CENTER, ALL MY CARE IS THROUGH THEM
QUALITY CARE FROM DOCTOR AND MEDICATIONS GIVEN
RYAN WHITE
RYAN-WHITE PROGRAM
SUPPORT FROM TERESA (HEALTH DISTRICT) Y KEAUNO (RYAN-WHITE)
THAT I'M FEELING SO MUCH BETTER WITH TREATMENT AND MEDICINE; MY LIFE SWITCH HAS
BEEN TURNED ON.
THE AMOUNT OF PAPERWORK IS LIMITING ME FROM ACCESSING THESE SERVICES
THE QUALITY OF CARE I RECEIVE FROM MY PRIVATE SPECIALIST
THE RYAN-WHITE CASE MANAGER
WELLNESS CENTER IN FRONT OF UMC
When asked about the most important services that help to keep them healthy the top five
were ranked as;
1.
2.
3.
4.
5.
HIV/AIDS medication
Medical care
Case management
Dental care
Eligibility services
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
41
What are important services that help keep you healthy overall? (select all that apply)
Answer Options
HIV/AIDS medication
Medical care
Case management
Eligibility services
Dental care
Assistance with health insurance co-payments and premiums
Mental health care
Food bank/food vouchers
Other (please specify)
Medical nutrition therapy (meeting with a dietitian)
Medical Transportation (bus passes)
Health education/risk reduction classes (Health Relationships or
Mothers, Sisters, Daughters)
Emergency financial assistance (with utilities and housing)
Support groups
Housing assistance (short term assistance with housing or referrals
for available housing)
Language interpretation services
Substance abuse treatment
Legal services (such as living will)
Child care services
Don't know
Prefer not to answer
Response
Percent
Response
Count
87.7%
82.7%
55.6%
45.7%
37.0%
28.4%
24.7%
24.7%
19.8%
18.5%
18.5%
71
67
45
37
30
23
20
20
16
15
15
16.0%
13
14.8%
13.6%
12
11
9.9%
8
7.4%
6.2%
4.9%
2.5%
0.0%
0.0%
6
5
4
2
0
0
answered question
skipped question
The “other” responses are listed in the table below and include items such as vision, food
pantry, counseling and self-motivation.
Other (please specify)
NOT USING SERVICES RIGHT NOW
CORRECTIVE LENSES (BI-FOCALS)
COUNSELING--ONE-ON-ONE
FOOD STAMPS
I HAVE RECEIVED NOTHING.
MY COUNSELOR, TERESA'S FOOD PANTRY, MY DAD'S INSURANCE
MY INSURANCE
MY INSURANCE
MYSELF--BY SLEEPING AND EATING RIGHT.
MYSELF--GETTING INTO A HEALTHY ROUTINE.
RYAN-WHITE B
81
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
RYAN-WHITE PROGRAM
SUPPORT SYSTEM AT HOME
SUPPORTIVE SOCIAL WORKERS
VISION CHECK
VITAMINS
When asked about the one service that is most important in keeping them healthy the
overwhelming majority, 55%, selected HIV/AIDS medication followed by medical care.
Other (please specify)
A COMBINATION OF ALL THREE: MEDICAL CARE, MEDICATION, HEALTHY ROUTINE.
BOTH HIV/AIDS MEDICATION AND MEDICAL CARE
CASE MANAGEMENT AND MEDICAL CARE
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
COMBINATION--YOU NEED MEDICAL CARE IN ORDER TO GET PRESCRIPTION FOR
MEDICATION
COUNSELING
I HAVE RECEIVED NOTHING.
MY DAD'S INSURANCE
MY INSURANCE
NOT USING SERVICES RIGHT NOW
RYAN-WHITE B, MY INSURANCE, AND MEDICATIONS
RYAN-WHITE PROGRAM
SUPPORT GROUPS AND RISK REDUCTION
A re a ny o f the fo llo wing s e rv ic e s d iffic ult fo r y o u to a c c e s s ? (s e le c t a ll
tha t a p p ly )
R e s p o ns e R e s p o ns e
P e rc e nt
Co unt
A ns we r Op tio ns
Other (please specify)
Dental care
Medical transportation (bus passes)
Transportation to recreational activities
Medical care
Vision care
Housing assistance (long term or permanent housing)
Specialty medical care
Mental health care
Food bank/food vouchers
Emergency financial assistance (with utilities and
Housing assistance (short term assistance with housing
Medical transportation (gas or taxi vouchers, van)
HIV/AIDS medication
Eligibility services
Medical nutrition therapy (meeting with a dietitian)
Assistance with health insurance co-pays and premiums
Legal services (such as living will)
Don't know
Nurse case managers at the Southern Nevada Health
Health education/risk reduction classes (Health
Support groups
Case management
Substance abuse treatment
Child care services
Language interpretation services
Prefer not to answer
68.7%
13.4%
9.0%
9.0%
9.0%
9.0%
7.5%
7.5%
6.0%
6.0%
6.0%
6.0%
6.0%
4.5%
4.5%
3.0%
3.0%
3.0%
3.0%
1.5%
1.5%
1.5%
0.0%
0.0%
0.0%
0.0%
0.0%
a ns we re d q ue s tio n
s k ip p e d q ue s tio n
46
9
6
6
6
6
5
5
4
4
4
4
4
3
3
2
2
2
2
1
1
1
0
0
0
0
0
67
22
When ask about difficulties they face while trying to access services the most difficult services
were listed as; Dental care, medical transportation and transportation in general, medical care,
vision care, housing and specialty medical.
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
The “other” comments are listed in the table below. The majority, 38 people, indicated that
none are difficult to access with others stating they do everything on their own, Medicaid and
transportation-car service.
N umb e r
1
1
1
1
1
1
38
1
1
Othe r (p le a s e s p e c ify )
EVERYTHING IS EASY FOR ME TO RECEIVE
I DO EVERYTHING ON MY OWN.
MEDICAID
MONEY WOULD BE THE ISSUE FOR RECEIVING ANY OF THESE SERVICES.
NONE ARE DIFFICULT FOR ME TO ACCESS (AT THE MOMENT)
NONE ARE DIFFICULT FOR ME TO ACCESS (SO FAR)
NONE ARE DIFFICULT TO ACCESS
TIME BETWEEN APPOINTMENTS AND COUNSELOR CALL BACKS
TRANSPORTATION--CAR SERVICE
When asked why those services are so difficult to access the themes include; confusion with the
cumbersome process for accessing care, not knowing where to get services, lack of
transportation or difficulty using public transportation, and the cost of vision and dental.
If any services are difficult for you to access, please tell us more about what makes them so
difficult below.
Response Text
(AFFORDABLE CARE ACT TOOK PLACE) BECAME A CONFUSING PROCESS
BACK AND FORTH/ TOO LONG OF PROCESS AND CONFUSION/ BIG CIRCLE
BECAUSE I WAS GOING THROUGH A CHANGE OF DOCTOR AND SOME PAPERS WEREN'T
FILLED OUT AND THEY WANTED A CD4 TEST EVEN BEFORE IT WAS 90 DAYS OLD.
COST AND NOT KNOWING WHERE TO ASK FOR THESE SERVICES.
DIFFICULT TO ACCESS BECAUSE OF LACK OF TRANSPORTATION.
FINANCIALLY IT'S HARD TO ACCESS MEDICAL CARE BECAUSE I'M JUST NOW GETTING ON MY
FEET BY GETTING A NEW JOB. I'M FOCUSED ON HAVING ENOUGH MONEY FOR MY
MEDICATIONS, AT THIS POINT.
FINDING THE PLACES TO GET IT DONE. FINANCIAL STANCE.
FOR THE MOST PART IS THE LACK OF KNOWLEDGE THAT THESE SERVICES EVEN EXIST.
HARD TO GET APPOINTMENT W/DENTISTS
HOUSING ASSISTANCE IS DIFFICULT TO ACCESS BECAUSE I'M BARELY GOING THROUGH THE
PROCESS. VISION CARE IT'S DIFFICULT BECAUSE MY INSURANCE DOESN'T COVER CONTACT
LENSES. MEDICAL TRANSPORTATION IS SOMETIMES DIFFICULT TO ACCESS BECAUSE IT
SOMETHING HAPPENS WITH THE BUS TRANSIT THEN I CAN'T GET TO WHERE I NEED TO GO.
I APPLIED TO GET DENTAL CARE BUT I HAVEN'T HEARD BACK FROM ANYONE ABOUT THAT.
I DON'T KNOW WHERE TO GET SERVICES LIKE BUS PASSES.
I DON'T QUALIFY BECAUSE I DON'T HAVE A JOB.
I HAVEN'T BEEN CONTACTED FROM THE RYAN-WHITE PROGRAM OR ANY OTHER PERSON FOR
THE LAST 5 MONTHS. ALSO, MY GENOME TESTS AT UMC WERE INCONCLUSIVE BECAUSE
THEY DID IT WRONG TWICE AND I JUST DECIDED TO LEAVE THE PROCESS AFTER THE SECOND
TIME MY LAB RESULTS WERE MESSED UP. THE GENOME WAS FOR THE DOCTOR TO
DETERMINE WHAT MEDICATIONS WERE BEST FOR ME.
I WOULD NEED FINANCIAL ASSISTANCE TO GET THESE SERVICES.
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
I'M UNAWARE OF MANY OF THESE SERVICES AND I'M CURRENTLY UNEMPLOYED SO I DON'T
HAVE THE MONEY FOR GAS TO GO TO APPOINTMENTS AND IN A WEEK I WON'T HAVE A
VEHICLE AT ALL (IT'S MY DAD'S).
IT'S JUST THE COST OF ACTIVITIES THAT IS DIFFICULT FOR ME.
LATELY I'VE BEEN HAVING ISSUES WITH THE CAR SERVICE BECAUSE I'VE BEEN LEFT WAITING
FOR 2 OR 3 HOURS AT THE DOCTOR'S OFFICE AFTER MY APPOINTMENT. THEY HAVE ALSO
CALLED ME AND SAID I'M NOT ELIGIBLE BUT CALLED AGAIN AND SAID I AM ELIGIBLE.
N/A--AHF AND MEDICAID MAKE EVERYTHING MORE ACCESSIBLE
N/A--I HAVEN'T REALLY TAKEN ADVANTAGE OF ANY OTHER SERVICES.
NOBODY TELLS ME WHERE TO GET TO GET ANYTHING, SO I WOULDN'T KNOW.
NONE
NOT KNOWING WHERE TO GO TO TAKE THE FULL ADVANTAGE OF THESE SERVICES, PRIDE
AND SHAME OF OTHER PEOPLE KNOWING ABOUT MY DIAGNOSIS.
THE CASE MANAGER HELPING ME THE SECOND TIME AROUND GETTING A LIVING STIPEND
FROM CLARK COUNTY (HENDERSON) WAS VERY RUDE, SO THAT MADE IT DIFFICULT FOR ME
TO GO THROUGH THE PROCESS. IN THE END, I RECEIVED THE HELP BUT THE LADY GAVE ME A
REALLY HARD TIME.
THE COST AND THE TIME IT TAKES TO GET TO MY DOCTOR'S APPOINTMENT. FOR FOOD
VOUCHERS, NO ONE TELLS YOU ABOUT HOW TO GET THEM.
THE COST OF DENTAL CARE IS EXPENSIVE, IT'S EITHER FOOD ON THE TABLE OR PAY FOR
DENTURES. IT'S HARD TO TRANSPORT MYSELF USING THE BUS LINES.
THE COST OF VISION AND DENTAL CARE.
WILL FIND OUT ABOUT ANY ADDITIONAL SERVICES HE QUALIFIES FOR TOMORROW AT A
DOCTOR'S APPOINTMENT.
When asked about the most important person, place, or thing that helped them seek medical
care in the beginning the overwhelming majority said it was family, followed themselves, and
then case management staff.
Overall, what is the most important person, place, or thing that helped you see an HIV
medical doctor for the first time?
Number
Response Text
10
CASE MANAGER
1
COMMUNITY COUNSELING CENTER.
1
COMMUNITY OUTREACH MEDICAL CENTER
1
EMERGENCY ROOM DOCTOR/ AND FARABI
15
FAMILY, INCLUDED; MOM, DAD, KIDS, GRANDKIDS, SISTER, BROTHER
6
FRIENDS.
1
GOD, MY RELIGION.
1
I DID IT ALL ON MY OWN.
1
I MOTIVATE MYSELF.
1
I WAS IN THE HOSPITAL AND DIAGNOSED THERE. THERE WERE OTHER
THINGS WRONG WITH ME, TOO.
1
MOBILE TESTING SITE ASSOCIATES THAT SET UP APPOINTMENT
1
MY COUNSELOR AT THE SNHD
1
MY HEALTH.
1
MY OWN PEACE OF MIND.
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
1
1
17
1
1
1
1
1
1
1
1
1
1
1
MY RESILIENCE AND WILL TO LIVE.
MY RESULTS AND MYSELF.
MYSELF
NURSE CASE MANAGER AT THE SOUTHERN NEVADA HEALTH DISTRICT
(SHARON)
SEVERAL PEOPLE AT THE FIRST AND THE SECOND CLINIC I WENT TO.
SOCIAL WORKER
SOUTHERN NEVADA HEALTH DEPARTMENT.
STEPS OF THE PROCESS OF FROM BEING REFERRED ALL THE WAY TO BEING
SEEN BY THE HIV MEDICAL DOCTOR. A LADY FROM THE HEALTH DISTRICT
CAME TO SEE AND TALK TO ME ABOUT PROGRAMS.
THE HEALTHCARE WORKER WHO WENT OVER ALL OF THAT WITH ME.
THE LADY WHO TOOK MY BLOOD AND DID THE HIV TEST.
THE LGBT COMMUNITY CENTER.
THE PERSON AT THE GAY AND LESBIAN CENTER ENCOURAGED ME TO SEEK
CARE.
THE RYAN-WHITE PROGRAM.
WANTING TO SEE MY MOTHER AGAIN.
Family was again the number one motivation for clients staying in HIV medical care followed by
the motivation within themselves, their health and concern about staying healthy.
Overall, what is the most important person, place, or thing that helps keep
you going to an HIV medical doctor?
Count
Response Text
25
FAMILY, INCLUDING; EX-HUSBAND, MOM, DAD, KIDS PARTNER,
FIANCE, HUSBAND AND SISTER
24
MYSELF
8
HEALTH/PEACE OF MIND/MY OWN WILLINGNESS TO STAY
HEALTHY
3
CASE MANAGER
3
GETTING MEDICATION
2
FRIENDS.
BESIDES MY RELATIONSHIP IT WOUDL BE MY RYAN-WHITE CASE
MANAGER.
COMMUNITY COUNSELING CENTER.
CURRENTLY THE PERSON AT THE SECOND CLINIC I GO TO.
GOD, HE GIVES ME STRENGTH TO KEEP GOING ON.
MY DOCTOR.
N/A, FIRST APPOINTMENT IS 5/26.
NOT USING SERVICES RIGHT NOW
QUALITY OF MEDICAL CARE
THE FACT THAT I HAVE HIV
THEY'RE ALL WONDERFUL--THE PEOPLE FROM THE CLINIC (UMC
WELLNESS CENTER).
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
Finally, respondents were given a chance to share any other comments they had regarding the
system of care. While most comments were positive difficulties included receiving calls back
from staff, cumbersome paperwork and processes.
What other comments or information would you like to share?
ANY SERVICES ARE HARD TO ACCESS FOR ME BECAUSE I DON'T KNOW ABOUT THEM. AFTER
THE SITUATION I WENT THROUGH WITH UMC I STOPPED EVERYTHING BECAUSE NO ONE HAD
CALLED TO CHECK UP ON ME, EITHER.
AWARENESS CENTER ON SHADOW LANE THE STAFF IS WONDERFUL. WELFARE DEPARTMENT
NEEDS TO BE AWARE THAT THEY NEED TO HELP A LITTLE MORE, JUST BECAUSE SOME ONE
DO HAVE A SMALL INCOME DOES NOT MEAN THAT IS NOT ENOUGH.
EVERYTHING IS GREAT. GREAT SERVICE.
I FEEL LIKE I'M RECEIVING VERY GOOD HEALTHCARE WITH THE UMC WELLNESS CENTER.
I HAD A PROBLEM WITH APPLYING FOR THE RYAN-WHITE PROGRAM BECAUSE I WAS DENIED
THE FIRST TIME I WENT THERE. MY EXPERIENCE WITH RYAN-WHITE HAS BEEN HORRIBLE:
COUNSELORS ARE DISORGANIZED AND UNHELPFUL. I WAITED IN THE OFFICE FOR AN HOUR
AND A HALF AND I WAS JUST OVERWHELMED WITH MANY THINGS THAT COUNSELORS TOLD
ME ABOUT BUT NEVER REALLY EXPLAINED TO ME (PERTAINING TO ASPECTS OF THE
PROGRAM).
I THINK IT'S WONDERFUL THAT THEY HAVE THESE PROGRAMS AND THAT THEY HELP US OUT.
I REALLY APPRECIATE IT.
I WOULD LIKE MORE INFO FOR HOW TO APPLY FOR FOOD STAMPS
I'M VERY HAPPY WITH MY DOCTOR BECAUSE I HAD ALMOST 1 MILLION BAD VIRUSES IN MY
BLOOD AND NOW I ONLY HAVE LESS THAN 99 UNITS IN MY BLOOD IN 6 MONTHS AND MY
DOCTORS WERE VERY HAPPY ABOUT THAT AND I'M HAPPY, TOO.
I'M VERY SATISFIED WITH THE RYAN WHITE PROGRAM AND I RECOMMEND IT TO ANY ONE
WHO MIGHT NEED IT.
INITIALLY THEY WERE ALL HELPFUL. MAKING AN APPOINTMENT AT UMC WITH THE
SPECIALIST IS A WHOLE OTHER ISSUE. IF I HAD TO CANCEL I COULDN'T GET ANOTHER
APPOINTMENT UNTIL A MONTH LATER.
IT HAS BEEN DIFFICULT FOR ME TO REMEMBER DIFFERENT THINGS AFTER MY STROKE,
WHICH IS WHY I WAS IN THE HOSPITAL IN THE FIRST PLACE. BUT I APPRECIATE THE SERVICES
OFFERED TO ME.
IT'S HARD TO REACH THE COUNSELORS AT THE CENTER ON ALMOND TREE LANE.
MANY THANKS, MAY GOD BLESS YOU FOR HELPING SO MANY PEOPLE LIKE ME.
MY CASE WORKER SUCKS, SHE DOESN'T TELL ME ABOUT THINGS, SHE DOESN'T SEEM TO
CARE. SHE JUST HANDS ME PAPERS AND THAT'S IT.
MY CONTACT AT AHF HAS BEEN WONDERFUL. I'D BE LOST WITHOUT HER.
N/A PROCESS IS VERY HELPFUL.
ST. TERESE HIV CLINIC AND AFAN HAVE BEEN EXCELLENT RESOURCES FOR ME. THEY'VE BEEN
VERY GOOD.
THANK YOU FOR ALL YOUR HELP. WE ALL SAY IT WON'T HAPPEN TO ME, BUT IT DOES
HAPPEN AND THANK YOU FOR THE SERVICES AND THE PEOPLE THAT HAVE HELPED ME
ALONG THE WAY.
THANK YOU. EVERY SOCIAL WORKER THAT I'VE WORKED WITH AND THE DOCTORS HAVE
BEEN INCREDIBLY HELPFUL. NOT JUST WITH GATHERING MY INFORMATION BUT THE WAY
THEY CARE FOR ME, THEIR MANNERS. I DON'T KNOW WHAT I WOULD DO IF THEY DIDN'T
EXIST.
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
THANK YOU. I'M VERY THANKFUL FOR ALL THE SERVICES BECAUSE WITHOUT THEM I
WOULDN'T BE HERE RIGHT NOW.
THE HEALTH DISTRICT DISCLOSED SOME INFORMATION TO A PAST PARTNER ABOUT THE
REASON WHY THEY WERE CALLING HIM THAT HELPED THE PAST PARTNER DEDUCE THAT
JUSTIN WAS THE ONE THAT GAVE THE DISTRICT THE INFORMATION, WHICH WAS SUPPOSED
TO BE CONFIDENTIAL.
THE HEALTH DISTRICT HAS BEEN GOOD TO ME. EVERYONE HAS BEEN VERY NICE.
THE HEALTH DISTRICT WAS BARELY THERE, TREATING ME MORE LIKE A NUMBER THAN A
PERSON.
THE PAPERWORK TO APPLY FOR THESE PROGRAMS IS PHENOMENAL AND IT DISCOURAGES
ME FROM APPLYING IN THE FIRST PLACE.
THE PEOPLE THAT ARE SUPPOSED TO HELP ME WITH GETTING SERVICES TAKE REALLY LONG
TO CALL ME BACK. THEY DON'T MENTION THE SERVICES AND THINGS THAT I CAN RECEIVE.
THERE ARE SOME THAT DON'T NEED THEM BUT GET IT ANYWAY.
THE PROGRAM IS GREAT FOR THE PEOPLE WHO NEED IT, AND EVEN THOUGH I DON'T NEED
IT THEY ALWAYS OFFER THAT THEY ARE THERE IN CASE I NEED THEM. COMFORT TO KNOW
THAT RYAN WHITE IS ALWAYS THERE.
THE PROGRAMS THAT RYAN-WHITE OFFERS AREN'T FOR EVERYBODY. IT'S MAINLY FOR
PEOPLE THAT DON'T HAVE INSURANCE OR VERY LITTLE COVERAGE, WHICH HASN'T HELPED
ME BECAUSE I'VE BEEN DEEMED OVERQUALIFIED FOR SOME SERVICES. IT MIGHT HAVE
SOMETHING TO DO WITH A BREACH OF CONFIDENTIALITY WITH MY DIAGNOSIS THAT I
MIGHT NOT BE RECEIVING ENOUGH HELP.
WE'VE BEEN REALLY HAPPY WITH THE AMOUNT OF HELP WE'VE BEEN GIVEN FROM RYANWHITE AND HEALTH CARE PROVIDER. EVERYTHING'S BEEN ACCESSIBLE DUE TO THE HELP.
WE REALLY APPRECIATE IT.
YOU GUYS ARE AMAZING, BEING ABLE TO HELP ME GET MY MEDICATION AND HELP ME
THROUGH THE PROCESS.
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
Recently Relocated
This survey was designed for Ryan White clients that have moved to the Las Vegas Area
(including Mohave County, AZ, Nye County, NV, and Clark County, NV) on or after July 1st, 2013
and are currently receiving HIV medical care.
Demographics and Insurance Information
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
50
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
HISPANIC
HISPANIC
LATINA
LATINO
LATINO
MEXICAN AMERICAN
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
56
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Count
48
4
1
1
1
City
LAS VEGAS
HERDERSON
NORTH LAS VEGAS
PAHRUMP
PARADISE
State
NEVADA
NEVADA
NEVADA
NEVADA
NEVADA
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
Diagnosis and Services Questions
58
Ryan White Part A HIV/AIDS Targeted Needs Assessment
The “other” comments are listed in the chart below.
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
PLANNED PARENTHOOD
FREE HEALTH CLINIC IN LOS ANGELES
PHOENIX INDIAN MEDICAL CENTER
REHAB
OVER THE PHONE WITH INSURANCE COMPANY
WORK SECRETARY OF HEALTH
NO PROFIT TESTING FOUND OUT ON THE JOB
PLASMA CENTER
PRIVATE CLINIC
HEALTH CENTER
WORK PLACE
IMMIGRATION
The majority of diagnosis were in California followed by Las Vegas with four clients reporting
they were diagnosed outside of the United States.
What city and state or country (if outside of the U.S.) were you living in when you initially
tested HIV positive?
Count
9
7
2
2
2
2
Response Text
NEVADA
LAS VEGAS NV
CALIFORNIA
LOS ANGELES, CA
SAN DIEGO, CA
CENTRAL, CALIFORNIA
NORTH HOLLYWOOD, CA
OAKLAND, CALIFORNIA
SACRAMENTO, CA
SAN LUIS OBISPO CALIFORNIA
CALIFORNIA
ILLINOIS
CHICAGO, ILLINOIS
AURORA, IL
DWIGHT, ILLINOIS
ROCKFORD ILLINOIS
LOUSIANA
NEW ORLEANS, LOUISIANA
ARIZONA
PHOENIX, AZ
NEW YORK
NEW YORK CITY, NEW YORK
Total by
State/Country
9
15
5
2
2
2
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
BROOKLYN, NEW YORK
TEXAS
DALLAS, TEXAS
COLORADO
DENVER, COLORADO
OHIO
DIYTON, OHIO
MICHIGAN
FLINT, MICHIGAN
IOWA
IOWA
NEW JERSEY
JERSEY CITY, NEW JERSEY
WYOMING
LUSK, WYOMING
ALABAMA
MOBILE, ALABAMA
TENNESSEE
NASHVILLE TN
NORTH CAROLINA
NORTH CAROLINA
NEBRASKA
OMAHA, NEBRASKA
PENNSYLVANIA
PITTSBURGH, PA
WASHINGTON
SEATTLE, WASHINGTON
KANSAS
WICHITA, KANSAS
OUTSIDE OF THE UNITED STATES
CUBA
SPAIN
DURBAN, SOUTH AFRICA
MEXICO
1
1
1
1
1
1
1
1
1
1
1
1
1
1
4
The majority of respondents indicated they moved here from California, Illinois, Texas and
Louisiana.
What city and state or country (if outside of the U.S.) did you move here from?
Number
4
2
2
Response Text
CALIFORNIA
LOS ANGELES CALIFORNIA
SAN DIEGO, CALIFORNIA
SACRAMENTO, CA
NORTH HOLLYWOOD, CA
Total by
State/Country
14
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
2
2
3
2
2
2
2
LONG BEACH CALIFORNIA
OAKLAND, CALIFORNIA
SANTA ROSA CA
CA
EL CENTRO, CALIFORNIA
ILLINOIS
CHICAGO, ILLINOIS
AURORA, IL
ZION, ILLINOIS
TEXAS
DALLAS TEXAS
HOUSTON, TEXAS
FLORIDA
MIAMI, FLORIDA
ORLANDO, FLORIDA
FLORIDA
LOUSIANA
NEW ORLEANS, LOUISIANA
UTAH
SALT LAKE CITY, UTAH
CEDAR CITY UT
ARIZONA
PHOENIX, AZ
LAKE HAVASU CITY, ARIZONA
GEORGIA
ATLANTA, GEORGIA
COLORADO
DENVER, COLORADO
WASHINGTON
SEATTLE, WASHINGTON
WASHINGTON
NEBRASKA
HASTING, NEBRASKA
LINCOLN, NEBRASKA
NEW YORK
BROOKLYN, NEW YORK
SOUTH CAROLINA
DUNN, SOUTH CAROLINA
MICHIGAN
FLINT, MICHIGAN
HAWAII
HONOLULU, HI
NEW HAMPSHIRE
NASHUA, NEW HAMPSHIRE
NORTH CAROLINA
NORTH CAROLINA
PENNSYLVANIA
PITTSBURGH, PA
4
3
3
3
3
3
2
2
2
2
1
1
1
1
1
1
1
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
MASSACHUSETTS
WEST FIELDS, MASSACHUSETTS
OUTSIDE OF THE UNITED STATES
LAS TUNA, CUBA
MEXICO
CUBA
1
3
The “other” comments are listed in the table below.
Other (please specify)
FROM PLANNED PARENTHOOD
GOT INFORMATION FROM HEALTH CLINIC I WAS DIAGNOSED AT; LOOKED FOR A DOCTOR
HIV DIRECTORY
OPEN DOOR CLINIC/REHAB
CALLED 1 800 NUMBER
HE WORKED IN THE HEALTH DISTRICT
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
FOUND OUT OWN RESOURCES
INSURANCE I USED TO HAVE HAD KAISER PERMANENT AS A PROVIDER
WORK (NON PROFIT HIV SUPPORT SERVICES)
WORKED AT GAY BAR AND WERE TESTED
RYAN-WHITE TRANSFERRED ME FROM LAS VEGAS TO NEBRASKA AND BACK TO LAS
VEGAS WHEN I MOVED BACK HERE ABOUT 2 MONTHS AGO
DID NOT KNOW OF ANY
LIFE FOUNDATION
PROMINENT DOCTOR IN AREA
PREVIOUSLY USED SERVICES
NEWLY DIAGNOSED
CONNECTED WITH ASSOCIATIONS
IMMIGRATION HOLDEE RECEIVED MEDICAL CARE THERE
PROMINENT SERVICES
NO CARE
WORD OF MOUTH
Respondents were asked about the HIV care where they used to live and the best thing about it.
Themes include;




Accessibility of services (all in one location, easy to get to)
Physicians (regular and nice)
Caring attitude of service providers
Timely access and follow-up
What was the best thing about the HIV care you received where you used to live
(outside the Las Vegas area)?
THE RESOURCES
MAINLY THE FREE TESTING BUT ALSO THE RESOURCES THROUGH THE SOCIAL WORKER
IMMEDIATE ACCESS TO DOCTORS, NURSES, PHARMACIES / HOTLINE NUMBER
NURSES AND DOCTORS
PHYSICIAN
FREE MEDICINE FROM ADAP
THAT IT WORKED/ ADMIN PROCESS WAS USER FRIENDLY
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HUMAN KINDNESS
GAVE OUT GIFT CARDS WHEN PEOPLE GOT TESTED OR TOOK MEDICINE
NON JUDGEMENTAL
HAD REFERRALS
ALL CONCENTRATED IN ONE AREA (ONE CENTRAL LOCATION)
EVERYONE SEEMED TO KNOW WHAT THEY WERE DOING
DOCTORS WERE REGULAR
VERY ACCESSIBLE
ENCOURAGED TO SIGN UP FOR DIFFERENT ASSISTANCE
VERY LITTLE BUREAUCRACY/ SPECIALIZED CLINIC/ FEW PATIENTS
ACCESSIBILITY (INSURANCE COVERAGE) / CUSTOMER SERVICE
ATTENTIVE CARING
MADE SURE YOU NEVER RAN OUT OF MEDICATION
THEY SENT MY MEDICATIONS TO MY HOME.
SUPPORT
SUSTAIN MY LIFE
CARING, CONCERNED, PATIENT
NOT SURE
CONSISTENT/ STAY ON TOP OF CUTTING EDGE MEDICAL CARE
NICE DOCTOR
GOOD ATTITUDE
GIVING MEDICATION
CASE MANAGERS WERE EFFICIENT
VERY HELPFUL
DIDNT HAVE TO PAY FOR ANYTHING
THEY TOOK CARE OF EVERYTHING. ALL FACILITIES IN ONE LOCATION
DOCTOR BECAME PRIMARY/ VERY CARING
PEOPLE
DIDNT HAVE TO WAIT FOR APPOINTMENT
DOCTORS WERE KNOWLEDGEABLE/ CARED
SOUTHWEST CENTER FOR HIV/AIDS
N/A
VERY COMPREHENSIVE
NOT SURE
VERY SUPPORTIVE AND CARING
EVERYTHING WAS IN ONE BUILDING
ACCESS TO DOCTORS
N/A
ALL IN THE SAME BUILIDNG
EVERYTHING WAS UNDER ONE ROOF
EVERYTHING
WAY THEY CHECKED UP ON YOU, TAKING MEDICATION
INFORMATION
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
What was the most difficult thing about the HIV care you received where you used to live
(outside of the Las Vegas area)?
Count
Response Text
14
NOTHING
LOCATION OF SERVICES
5
LONG COMMUTE
MEDICATIONS
GETTING MEDICATION
HIGH COST OF MEDICATION
MEDICATION ARE IMPORTED AND TOOK LONG TO RECEIVE
THE REGIMEN TAKING THE PILLS
NOT BEING ABLE TO GET MEDICINE
HAVING TO CHANGE FROM MEDICATION TO MEDICATION
RESOURCES
VERY LIMITED HELP IN THE S. UTAH
LIMITED HEALTH CARE HIV INDIVIDUALS
LIMITED RESOURCES
FINDING SUPPORT GROUPS
THEY HAVE NO FOOD BANK IN NEBRASKA.
ACCCESS
APPOINTMENTS TOOK TOO LONG TO RECEIVE
DIDN'T HAVE ACCESS/ HAD TO GET ANALYSIS OUT OF CENTER
HARD TO GO INTO PROCESS
THEY HAVE NO FOOD BANK IN NEBRASKA.
TOOK VERY LONG TO RECEIVE CARE
COST
THE PRICE/COST
FIGHTING ABOUT INSURANCE BENEFITS
DID NOT RECEIVE SOCIAL SECURITY/FINANCIAL ASSISTANCE
DOCTORS/MEDICAL FACILITIES
DOCTORS - TOO ROBOTIC NOT SYMPATHETIC
MEDICAL CONDITIONS/ DIRTY
NO PROFESSIONAL CARE
SEEING A DOCTOR
PERSONAL ISSUES
GOING IN
GOING INTO A CLINIC AND THEM KNOWING ABOUT MY HIV STATUS
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Comments included; educational pursuits, health care/doctors, and other medical issues. All are
included in the table below.
Other (please specify)
MOSTLY FOR SCHOOL
EDUCATION OPPORTUNITIES
LIKED FORMER DOCTOR
CHEAPER RENT / BETTER DOCTORS
LOWER COST OF LIVING
MENTALLY / SOCIAL/ EMOTIONAL STRESS (DISCRIMINATION)
RHEUMATOID ARTHRITIS
WAS DEPRESSED AND WANTED TO MOVE BACK TO LAS VEGAS
HEALTH CARE
HEALTH MOVED TO US FOR HEALTH
LOST HOME
BETTER TREATMENT
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The majority of clients heard about services in Las Vegas from case management staff with
“other” comments including phone book, prior experience, LGBT Community Center, and Tribal
Clinic.
Other (please specify)
TRIBAL CLINIC
ALREADY HAD A PREVIOUS DOCTOR
PRIOR EXPERIENCE LIVING IN LAS VEGAS
AHF
COMMUNITY EVENT WITH FREE HIV TESTING
I HAD PREVIOUS CONTACT WITH RYAN-WHITE
GAY&LESBIAN CENTER
YELLOW PAGES
AFAN / CASE MANAGER
AFAN
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USED TO MANAGE IT
AFAN
WORD OF MOUTH
LOOKED UP PHONE BOOK
The majority of respondents rated HIV care in the Las Vegas area as excellent, 27%, and very
good, 21%.
Respondents were asked what the best thing about HIV care is in Las Vegas, themes included;
the attitude of service providers, access to care, doctors and medications, knowledgeable staff,
location of service providers, with a few stating “nothing” or “not sure”. All comments can be
found in the chart below.
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What is the best thing about the HIV care you receive here (in the Las Vegas area)?
Count
Response Text
ATTIITUDE/CARING
ACTUALLY TRY TO HELP & CARE ABOUT YOUR ILLNESS
AIDS HEALTHCARE FOUNDATION VERY CAREFUL/CARING
ATTENTIVE
CARING AND HELPFUL SEEK ANSWERS
OFFER ASSISTANCE
PEOPLE
SUPPORT
PEOPLE ARE RESPONSIBLE
THE STAFF AT THE AHF / MEDICATION WORKS
THE WAY THEY ARE. DELIVERIES.
THEY CHECK UP ON YOU
VERY CONSIDERATE/SUPPORT TEAM CONVENIENTLY LOCATED
VERY SWEET PEOPLE/ BETTER MEDICATION
WILLINGNESS TO HELP OUT/ HOUSING ASSISTANCE
WONDERFUL CASE MANAGER AT AFAN /ST THERESA HIV OUT CENTER IN
HENDERSON
ACCESS
ABILITY TO SEE A DOCTOR
ACCESSIBLE / FOLLOW UPS
THE SERVICES, MEDICAL CARE, HOW QUICKLY SEEN, ACCESSIBILITY
EASY ACCESS MOBILITY (DOCTOR AND PHARMACY LOCATED NEAR EACH OTHER)
MORE ACCESS TO DIFFERENT SERVICES
INITIAL INTAKE WAS QUICK
ALL THE BENEFITS (ASSISTANCE W/ FOOD STAMPS/RENT)
DOCTORS
DOCTOR IS VERY EXPERIENCED
DOCTORS
DOCTORS ARE CARING
THE DOCTOR JERRY CADE VERY HELPFUL
A LOT LIKE OAKLAND (FEW PATIENTS/ A LOT OF 1-ON-1 ATTENTION)
GREAT DOCTOR/ VERY UNDERSTANDING
MEDICATIONS/PHARMACY ASSISTANCE
MEDICATION DELIVERED
ALL IN ONE PHARMACY
INSTEAD OF TAKING 6 PILLS HES ONLY TAKING 1. 100% UNDETECTABLE
REFILLS
THAT I CAN RECEIVE MEDICATIONS.
KNOWLEDGEABLE STAFF/FOLLOW-UP
KNOWLEDGEABLE
FOLLOW UP/COUNSELING GOOD CONSISTENT CONTACT
LOCATION OF SERVICE PROVIDERS
CLOSE TO HOME
CLOSER TO LOCATION
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5
5
EVERYTHING
EVERYTHING, HELP IS TREMENDOUS
SUPPORT GROUPS
HIV SUPPORT GROUP AT THE CENTER
NOT SURE
NOTHING
NOTHING SPECIFICALLY GOOD
I HAVE YET TO FIND IT; LOOKING FOR SERVICES IS NOT EASY AT ALL.
I HAVEN'T REALLY RECEIVED ANY CARE HERE
When asked about the most difficult thing to receiving care in the Las Vegas area, themes
included; location of providers, transportation issues, wait times, cumbersome paperwork,
doctors, and overall the entire process of finding and enrolling in services.
What is the most difficult thing about the HIV care you receive here (in the Las Vegas area)?
Count
Response Text
ACCESS
NEED TO GO TO 20 PLACES FOR DIFFERENT SERVICES
ACCESSIBILITY (SOUTHWEST) / CLERICAL / APPOINTMENT OUT TOO LONG / BAD
COMMUNICATION / LOST PAPER WORK
CALL TO MAKE APPOINTMENTS AND NO ONE ANSWER
GETTING AN APPOINTMENT
WAIT TIMES
CONSULTATIONS TAKE TOO LONG
FINDING INFORMATION
LONG WAIT NO GOOD FACILITIES /BAD BLOODING DRAWING
LONG WAIT TIME DURING APPOINTMENT / STAFF SEEMS NOT TO CARE
GETTING AN APPOINTMENT IN A TIMELY MANNER
TRANSPORTATION
TRANSPORTATION TO DOCTORS
TRAVEL
LONG COMMUTE/TRAVELING/LONG WAIT LIST FOR PRIMARY
GETTING TO AND FROM SERVICES
MEDICATION
COST OF MEDICATION EXPENSIVE
TRYING TO GET MEDICATION/ TRYING TO GET SERVICES
I HAVEN'T HAD MY MEDICATIONS IN OVER 12 DAYS AND COUNTING BECAUSE OF
PAPERWORK ISSUES.
GETTING MEDICATION
CUMBERSOME PAPERWORK
HAD TO DO PAPERWORK HIMSELF
EVERYTHING, PAPERWORK, LACK OF SUPPORT, TOO MANY LOCATIONS
PAPERWORK
A LITTLE BIT MORE PAPERWORK
DOCTORS
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15
DOCTORS ARE DESENSITIZED - NOT EMPATHETIC
FINDING A REGULAR, SPECIALIST DOCTOR THAT I CAN GO TO.
HEALTH INSURANCE/MEDICAID ISSUES
FRUSTRATING FOR INSC.
HEALTH INSURANCE. YOU NEED TO WORK FOR BIG EMPLOYER TO RECEIVE HEALTH
CARE
MEDICAID WOULDNT PAID FOR MEDICINE
ENTIRE PROCESS/KNOWLEDGE OF SERVICES
PROCESS OF ACTUALLY RECIEVING CARE
RYAN WHITE HARD TO COORDINATE TOO MANY ENTITIES
SWITCHING TO THE NEW HEALTHCARE SYSTEM / ADAP
THE LACK OF STATE FOUNDING
THERE ARE NO RESOURCES, YOU REALLY HAVE TO GO OUT ON YOUR OWN AND
FIND OUT WHAT TO DO ON YOUR OWN
NOTHING
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Other (please specify)
NOT SINCE I'VE MOVED BACK HERE
The number one reason respondents got into care within 3 months of moving to Las Vegas was
to continue care and medication they were receiving previous, followed by their health and the
need to live.
You stated you saw an HIV medical doctor within 3 months of moving here, what motivated
you to seek care?
Count
Response Text
CONTINUE CARE/MEDICATION
7
CONTINUE CARE
CONTINUE TO FOLLOW REGIME
CONTINUE TREATMENT AND STAY HEALTHY
NEEDED MEDICATION
NEEDED MEDICATION / CONTINUE TREATMENT/ SUPERVISE HEALTH
NEEDED TO CONTINUE CARE
PRESCRIPTIONS CONTINUE CARE
RUNNING OUT OF MEDICATION
RUNNING OUT OF MEDICATION
LOST MEDICATION SO WAS TRYING TO GET IT BACK
MAINTAIN REGIMEN
THE SAFETY AND ASSURANCE THAT I WOULD HAVE THE MEDICATION THAT I
NEED.
WANTED TO CONTINUE MEDICATION
MEDICATION
GET MY MEDICATION
HEALTH/DON'T WANT TO DIE
DONT WANT TO DIE. TAKE CARE OF HEALTH
GOTTA HAVE GOOD HEALTH
HEALTH
HEALTH WANTING TO LIVE
MY HEALTH WAS FAILING
STAY HEALTHY
STAY HEALTHY
STAYING HEALTHY
STAYING LIVIGN
WANTED TO LIVE
WANTING TO LIVE
WANTING TO TAKE CARE OF MYSELF
TAKE CARE OF HEALTH
TAKE HIS LIFE WITH HIV VERY SERIOUSLY
THE MOVE/STARTING OVER NEW INTEREST IN TAKING CARE OF MYSELF
BEING ABLE TO HAVE A STABILITY
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MYSELF
SICK
BECAUSE I WAS SICK WITH FEVER AND NEEDED MEDICAL ASSISTANCE.
FEELING HORRIBLE/SICK
INSURANCE
RECEIVED INSURANCE
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Other (please specify)
N/A
I WAS USING A PRIMARY CARE DR.
N/A--IT TOOK ABOUT 1 MONTH TO GET MEDICAL CARE.
DID NOT HAVE CERTIFICATION
Other (please specify)
SOUTHERN NEVADA HEALTH DISTRICT (TESTING)
ALREADY HAD A PREVIOUS DOCTOR
MEDICATION
PRIMARY CARE REFERRAL
ALTERNATIVES
AFAN
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MY HEALTH
WORRIED ABOUT HEALTH
MYSELF
RESEARCH
NEEDED MEDICATION
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Other (please specify)
WELLNESS CENTER BY UMC
HEALTH DEPARTMENT
RYAN WHITE / MEDICAID
MEDICAID
AFAN / PHARMACY
AFAN
AFAN / ADAP
AFAN
SAW A NURSE PRACTITIONER THROUGH AIDS HEALTHCARE FOUNDATION
NURSE CARE AT THE CLINIC WHERE I GO
RYAN WHITE
AFAN/ GOLDEN RAINBOW
RYAN WHITE
AFAN
RYAN WHITE PART B & AFAN
PHARMACY
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The “other” comments are listed in the table below, they primarily state “myself”, doctors, or
specific Ryan White organizations.
Other (please specify)
HEALTH DEPARTMENT
MYSELF
PRIMARY CARE REFERRAL TO SPECIALIST
CLINIC FROM LOS ANGELES
WOMAN AT ELIGIBILITY SERVICES
CLINIC THROUGH AIDS HEALTHCARE FOUNDATION
AFAN
DOCTOR AT UMC
RYAN-WHITE PROGRAM
MYSELF
AHF DOCTORS
DOCTOR
DOCTOR WELLNESS CENTER (SHADOW LANE)
AHF
AFAN
HIV MEDICAL DOCTOR
MYSELF
AFAN
MYSELF
AFAN
RYAN WHITE
AFAN
ON HER OWN
Respondents stated that the one service that helps to keep them in HIV medical care at this time
is HIV/AIDS medication, Case management/Social Workers, and in the “other” comments again
they list “myself” and specific Ryan White organizations.
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Other (please specify)
MEDICAID
HEALTH DEPARTMENT
RYAN WHITE / MEDICAID
CLINIC
COUNSELOR
CLINIC THROUGH AHF
MYSELF
HEALTH
RYAN WHITE
HEALTH
EVERYTHING WORKS TOGETHER
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AHF
RYAN WHITE CASE MANAGER
AFAN
ALL SERVICES
MYSELF
WELLNESS CENTER
MYSELF
MYSELF
ON HIS OWN
AFAN
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Other (please specify)
I HAVE RECEIVED RIDES FROM SOMEONE WHO WORKS FOR THE HEALTH DISTRICT
CLINIC THROUGH AHF - NURSE PRACTITIONER
RYAN WHITE
ST THERESA CENTER/AIDS HEALTH FOUNDATION
ALL SERVICES
REGULAR CHECK UPS
SELF
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Other (please specify)
HIV/AIDS MEDICATION AND MEDICAL CARE, BOTH
GIRL AT ELIGIBILITY SERVICES
AIDS HEALTHCARE FOUNDATION
MEDICAL INSURANCE THAT COVERS ME
NONE ARE MOST IMPORTANT. ALL COMPONENTS MATTER EQUALLY
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Other (please specify)
NONE ARE DIFFICULT FOR ME TO ACCESS
NONE ARE DIFFICULT FOR ME TO ACCESS
PHARMACY / ADAP
NONE ARE DIFFICULT FOR ME TO ACCESS
I WOULD LIKE ASSISTANCE TO MOVE BACK TO NEBRASKA BECAUSE I HAD BETTER CARE
THERE THAN HERE, EVEN THOUGH THEY DIDN'T OFFER A FOOD BANK.
MEDICAL INSURANCE
N/A
When asked about what makes those services difficult to access clients said; paperwork, long
commutes and available transportation options, insurance and Medicaid issues, and the overall
process can be difficult at times.
If any services are difficult for you to access, please tell us more about what makes them
so difficult below.
BEEN CALLING AND HAVE NOT RECEIVED NEEDED INFORMATION TO BOOK APPOINTMENT
COMMUNITY HEALTH WOULD NOT HELP. DIFFICULT AND CONTINUOUS PROCESS OF
PAPERWORK TO GET INTO RYAN WHITE PART A DENTAL CARE. NO HELP ON THE PHONES.
DENIED RYAN WHITE PART B. GIVEN CARD THAT DIDNT WORK. WALGREEN PEOPLE INPUT
INFO INCORRECTLY. HAD TO GO TO AVELLA
FINDING LOCATIONS AND TIMES THAT COINCIDE WITH ME GETTING THERE
FINDING SOMETHING NEARBY THAT ACCEPTS MY INSURANCE. HAVE TO SCHEDULE
APPOINTMENTS SO FAR AHEAD WOULD BE INCONVENIENT (21/2 HRS COMMUTE)
SHADOW LANE
HAVE NOT HAD THE CHANCE TO SEE WHERE TO GO
HEALTH DISTRICT WAS DIFFICULT & PROCESS AND APPOINTMENTS
LOCATION AND TAKING BUSES EVERYWHERE
MEDICAID(EMERGENCY TEMPORARY) RYAN WHITE PART A
MEDICAL CARE/ BETTER DOCTOR/LONG WAIT AT FACILITIES
NOT SURE
PROBABLY PERSONAL DENIAL / LOCATION- LONG COMMUTE
SERVICES WERE DIFFICULT TO ACCESS BEFORE THE AFFORDABLE CARE ACT.
THE COST OF THESE SERVICES MAKE THEM DIFFICULT TO ACCESS AND BECAUSE RYANWHITE HASN'T HELPED ME WITH GETTING MY MEDICATION IN THE PAST 12 DAYS. I NEED
TO ENROLL IN RYAN-WHITE B BUT HAVEN'T BEEN ABLE TO DUE TO PAPERWORK ISSUES.
TIME RESTRICTIONS
TOO MUCH PAPERWORK EVERY 6 MONTHS NEEDS TO BE RENEWED (FORGOT TO RENEW
SO WENT WITHOUT MEDICATION)
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Overall, what is the most important person, place, or thing that helped you see an HIV
medical doctor once you moved to the Las Vegas area?
Number Response Text
3
3
3
3
2
7
2
PERSON
DOCTOR
FRIEND
MYSELF
SOCIAL WORKER
CASE MANAGER
FAMILY
FORMER ACQUAINTANCE/FRIEND
MOTHER
MOTHER/FAMILY
MY DAUGTHER
MY FAMILY, SPECIFICALLY MY SISTER.
MY HUSBAND
MY PARTNER
NURSE AT UMC
TERRY SCHRUST ELIGIBILITY MANAGER
CASE WORKER AT RYAN WHITE
LADY NAMED VICTORIA AT THE SOUTHERN NEVADA HEALTH DISTRICT (CASE
WORKER?)
THERAPIST - WENDY (AFAN)
GOD
PLACE
AFAN
AHF
AIDS HEALTHCARE FOUNDATION
UMC
THING
MY HEALTH
CONTINUING TREATMENT
MOTIVATION TO CONTINUE CARE
MY PEACE OF MIND.
COMPUTER BECAUSE OF RESEARCH
MEDICINE
THE INTERNET A FRIEND WENT WITH ME FOR MORAL SUPPORT AT TESTING SITE
Overall, what is the most important person, place, or thing that keeps you going to an HIV
medical doctor here in the Las Vegas area?
Count
Response Text
PERSON
13
MYSELF
2
GOD
DOCTORS
FAMILY
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FAMILY & SOCIAL WORKER
FIANCE
HUSBAND
CASE WORKER AT RYAN WHITE
MOTHER
MOTHER/FAMILY
MY DAUGHTER
MYSELF & MY PARTNER
THE GIRL FROM THE ELIGIBILITY SERVICES
7
BETHANNE GRAMHAM
MY HUSBAND
MY KIDS.
SOCIAL WORKER
MY FRIEND
PLACE
PEOPLE OF AHF
THING
HEALTH
CONTINUING TREATMENT
COUNSELING (COUNSELOR ENCOURAGES HER TO SEEK CARE)
MEDICATION
MY LOVE OF LIFE
MYSELF MEDICATION
NOT CURRENTLY SEEN A DOCTOR N/A IN LAS VEGAS
REMAIN HEALTHY
WANTING TO LIVE
WANTING TO LIVE LIFE TO THE FULLEST AND BE HEALTHY
Respondents were given the opportunity to add any additional comments they had surrounding
services.
What other comments or information would you like to share?
AFAN SUCKS. THE AFFORDABLE CARE ACT SAVED MY LIFE.
CALL PLACES AND THEY NEVER REACH OUT BACK. MAKES IT DIFFICULT FOR YOU TO GET AN
APPOINTMENT.
I LOVE THE CARE HERE. IT IS OUTSTANDING. NEW ORLEANS WAS A STRUGGLE.
IN GENERAL MY STAY HERE IN LAS VEGAS HAS CHANGED MY LIFE BECAUSE I HAVE FOUND
PEOPLE THAT CARE ABOUT ME
I'VE BEEN PLEASANTLY SURPRISED BY QUALITY OF HEALTHCARE. RYAN WHITE/ AIDS
HEALTHCARE FOUNDATION HAVE BEEN VERY GOOD TO ME.
LOOKING FORWARD TO SUPPORT GROUPS
MEDICAL TRANSPORTATION IS HORRIBLE. EITHER SHOWS UP LATE OR DOESN'T SHOW UP AT
ALL.
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NEED TO CENTRALIZE SERVICES. MORE UNIFORM.
AFAN NEEDS TO BE BETTER.
NICE TO SEE MORE SERVICE IN THE DEVELOPING AREAS.
ONE STOP SHOP WOULD BE SO HELPFUL. ESPECIALLY SINCE HIV + DONT HAVE THE ENERGY
AND THE FUNDS FOR TRANSPORTATION. SO IT WOULD BE A FINANCIAL BENEFIT TO THE CITY
AND ORGANIZATION TO HAVE IT UNDER ONE ROOF.
OVERALL A GOOD PROGRAM. HELPS PEOPLE THAT CANNOT AFFORD INSURANCE
SOME OF THE QUESTIONS NEED TO BE RESTRUCTURED.TO REFLECT THAT MULTIPLE SERVICES
HAVE EQUAL WEIGHT TO THE HEALTH OF HIV CARE
THANK YOU FOR THE HELP.
THERE ARE NO RESOURCES FOR PEOPLE THAT ARE HIV-POSITIVE. I FEEL SERVICES IN NEVADA
ARE NOT ACCESSIBLE, WHICH IS WHY MANY PEOPLE ARE NOT IN CARE.
VERY APPRECIATIVE, SUPPORT IS GREAT VERY KING
VERY HAPPY WITH CASE MANAGER. AND THERE SHOULD BE MORE SUPPORT FOR PEOPLE
WITH HIV
VERY HAPPY WITH SOCIAL SERVICES HOPES TO AFFORD MEDICATION MEDICARE
WAIT TIME IS WAY TOO LONG. THEY TELL ME TO GET THERE EARLY BUT THERE IS NO POINT
SINCE THEY TAKE AN HOUR AFTER MY APPOINTMENT TO SEE ME. WHEN I COMPLAIN TO THE
STAFF THEY DO NOT SEEM TO CARE.
Returned to Care
This survey is only for Ryan White clients that have NOT received HIV medical care in the past
for 6 months or more but are currently in care.
Demographics and Insurance Information
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Other (please specify)
LOST HIS WALLET AND NEDDED ID
WEILL ON JUNE 1ST
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88
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
HISPANIC
HISPANIC
HAITIAN
LATINO
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
90
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
GETTING A TATTOO
ACCIDENT: WAS PRICKED BY A NEEDLE AT THE PARK WHILE PLAYING VOLLEYBALL
RAPE
BLOOD TO BLOOD CONTACT
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
93
Ryan White Part A HIV/AIDS Targeted Needs Assessment
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Where do you currently live? (write homeless if without a home)
Count
49
2
1
1
City
LAS VEGAS
HENDERSON
NORTH LAS VEGAS
KINGMAN
Diagnosis and Services Questions
State
NEVADA
NEVADA
NEVADA
ARIZONA
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Other (please specify)
GAY CENTER
LIFE INSURANCE
THE GAY AND LESBIAN COMMUNITY CENTER OF SANTA BARBARA
What city and state or country (if outside of the U.S.) were you living in when you
initially tested HIV positive?
Count
Response Text
27
NEVADA
27
LAS VEGAS, NV
14
CALIFORNIA
7
LOS ANGELES, CA
FRESNO, CA
CONCORD, CA
NORTH HOLLYWOOD, CA
OAKLAND, CA
SAN DIEGO, CA
SAN FRANCISCO, CA
SANTA BARBARA, CA
2
GEORGIA
ATLANTA GA
DALTON, GA
3
NEW YORK
KINGSTON, NY
NEW YORK NY
UTICA, NY
1
OHIO
CLEVELAND, OH
1
MISISSISSIPPI
JACKSON, MI
1
ARIZONA
PHEONIX, AZ
1
UTAH
SALT LAKE CITY, UT
1
FLORIDA
SOUTH BEACH, FL
1
KANSAS
WICHITA, KS
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Other (please specify)
JUST NEED TO GO DOWN
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Thinking back to when you had not seen the doctor for more than 6 months, what
motivated you to see the doctor again?
Count Response Text
12
WANTED A CHECK-UP/HEALTH
TO GET HEALTHY AGAIN
TRY TO KEEP UP WITH HEALTH
WAITED FOR A CHECK UP
WANTED TO CHECK UP
WANTED TO GET CHECK UP
SEE HOW I WAS DOING
MAKE SURE I WAS WELL
PLANNING TO MOVE AND WANTED TO MAKE SURE EVERYTHING WAS FINE
JUST TO MAKE SURE EVERYTHING WAS OKAY.
TAKE BETTER CARE OF YOURSELF
CONDITION
WANTING TO MAKE SHE WAS OKAY
9
FELT SICK
I GOT VERY SICK WITH PNEUMONIA.
FELT SICK
VIRAL COUNT WAS RISING. SICK. RYAN WHITE PROCESS WAS TAKING TOO LONG.
WAS NOT FEELING WELL ANYMORE
I WAS SICK.
NOT FEELING WELL
I PREVIOUSLY HAD NEVER SEEN A DOCTOR AND I HAD FELT FINE BUT I NOTICED
SOME CHANGES IN MY OVERALL HEALTH AND IT PROMPTED ME TO SEE WHERE I
WAS IN LEVELS AND SEEK TREATMENT.
SYMPTOMS
GOT SICK
5
FAMILY/FRIEND ENCOURAGEMENT
MY FAMILY
MY KIDS.
MY PARTNER
SOME ONE PASSING
FAMILY MADE ME GO BACK
5
FOUND OUT ABOUT PROGRAMS/SERVICES
FINDING A WAY TO GET HEALTHCARE. ALSO HAD CONCERNS
HEARD OF RYAN WHITE. WAS ABLE TO AFFORD TREATMENT THROUGH THE
PROGRAM.
I WAS ALWAYS MOTIVATED BUT COULD NOT. EVERYONE SWITCHED TO
AFFORDABLE ACT AND WAS TRYING TO GET MEDICAL BUT COULD NOT.
NEW PROGRAM
THE ASSISTANCE OF THE RYAN-WHITE PROGRAM
5
INSURANCE
GETTING INSURANCE
GOT MY INSURANCE
SICKNESS
DOCTORS WOULD NOT TAKE HER INSURANCE. FINALLY, A SPECIALIST WOULD
ACCEPT HER. DOCTORS ADVISED HER TO CONTINUE TREATMENT
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4
3
3
3
I DIDN'T HAVE INSURANCE TO GO SEE A DOCTOR. I WAS UNAWARE OF THE AIDS
HEALTHCARE FOUNDATION.
PERSONAL BARRIERS
SUBSTANCE ABUSE PROBLEM
OUT OF DEPRESSION
I GOT OUT OF JAIL.
PEOPLE CAME AND TOLD HIM OR THEY WOULD THROW HIM OUT
SOUTHERN NEVADA HEALTH DISTRICT CALL
CALL FROM THE HEALTH DEPT
THE SOUTHERN NEVADA HEALTH DISTRICT CALLED ME AND TOLD ME THAT I
NEEDED TO RETURN TO CARE.
SOMEONE CALLED FROM THE HEALTH DISTRICT
PROGRAM BARRIERS
DID NOT HAVE HIS ID
LAB WORK
I HAD A BIG PROBLEM WITH MY MEDICATION CO-PAYS AND I COULDN'T AFFORD TO
PAY FOR MY MEDICATIONS. I GOT THAT FIGURED OUT AND NOW I'M IN
TREATMENT AGAIN.
OTHER
RAN OUT OF MEDICINE
SEE A BETTER DR. THAN A GP
T CELL FAILED
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Ryan White Part A HIV/AIDS Targeted Needs Assessment
102
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
UNEMPLOYED; IT WAS DUE TO DISPLACEMENT (MOVING FROM ONE CITY TO
ANOTHER)
BEFORE OBAMACARE I COULDN'T BUY ANY TYPE OF INSURANCE FOR MY CONDITION;
I WAS OFF MEDICATION FOR 9 MONTHS FOR THE PROCESS TO GO THROUGH
ATTEMPTED TO SEEK TREATMENT SEVERAL TIMES BUT THE REQUIREMENTS AND
AMOUNT OF PAPERWORK DISCOURAGED ME
CO-PAYS WERE TOO MUCH FOR ME TO PAY THEM EVERY TIME FOR MEDICATIONS
I WAS JUST OUT PARTYING AND HANGING OUT WITH FRIENDS
FAMILY PROBLEMS
ABUSIVE RELATIONSHIP
I WAS DEPRESSED AND DIDN'T CARE, THOUGHT I WAS GOING TO DIE.
MOVED AND DID NOT HAVE A DOCTOR
WANTED HIM TO RE APPLY AND HAD TO WORK AND COULDNT TAKE DAYS OFF WORK
PARTNER WAS ILL
THEY STOPED GIVING MEDS TO PEOPLE
DEPRESSED
NEEDED DOCTOR TO ACCEPT HER INSURANCE
LOST MY I.D AND OTHER PAPERS
DOC KEPT RESCHULDING
DIDN'T NEED TO GO
MEDICATIONS DID NOT AGREE WITH ME
103
Ryan White Part A HIV/AIDS Targeted Needs Assessment
104
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
AFAN
BLOOD WORK WAS DONE
BLOOD WORK WAS DONE
CASE WORKER AT UMC WELLNESS
COMUNITY OUTREACH
DOCTOR
ELIGIBILITY SERVICES
FOOD STAMPS
HOSPITAL (SPRING MOUNTAIN)
LABS
LABS
LABS
MEDICAID
MEDICAID; RYAN-WHITE PROGRAM
NV CARE CENTER
RYAN WHITE PART A&C
RYAN WHITE PART A&C
RYAN WHITE/ADAP
RYAN-WHITE PROGRAM; APPLIED AND QUALIFIED FOR MEDICAID
VISION
105
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
COMMUNITY OUTREACH HEALTH CENTER
COULD NOT GET OUT OF BED
CT SCAN
GREATER UNDERSTANDING
106
Ryan White Part A HIV/AIDS Targeted Needs Assessment
HEALTH DEPARTMENT CALLED
I GOT OUT OF JAIL
I MOTIVATED MYSELF FOR MY OWN HEALTH
MEDICATION
MY HEALTH AND SON
MYSELF
RYAN WHITE
RYAN WHITE PROGRAM
STAY HEALTHY
TO GET MEDICATION
TOO MUCH PAIN
WANTED TO MAKE NUMBERS WERE GOOD
WANTED TO MAKE NUMBERS WERE GOOD
WANTED TO WORK
WAS GETTING HELP PAY FOR IT
107
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
AFAN
AFFORDABLE CARE ACT ALLOWING YOU TO BUY INSURANCE COVERAGE IF I NEEDED TO
BETTER DR
DOCTOR
FAMILY
GETTING OUT OF JAIL
108
Ryan White Part A HIV/AIDS Targeted Needs Assessment
HAVING INSURANCE
HEALTH DEPT CALLED
HEALTH DEPT
INSURANCE THROUGH JOB
MY ROOMMATE
OUT REACH
PARTNER WENT IN
RYAN WHITE
RYAN WHITE
RYAN-WHITE PROGRAM
SNHD
THE DOCTOR FROM THE HOSPITAL
TRYING TO GET A CT SCAN
WAS SICK
109
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
CASE MANAGEMENT AND HIV/AIDS MEDICATION-BOTH ARE EQUALLY IMPORTANT
GOLDEN RAINBOW AND AFAN
HOPE IN GETTING THE CT SCAN
INSURANCE
IT'S JUST ME, I DO IT ALL MYSELF
MEDICAID
MY DOCTOR
MYSELF
OUT REACH
RYAN WHITE
RYAN WHITE
RYAN WHITE
110
Ryan White Part A HIV/AIDS Targeted Needs Assessment
RYAN WHITE
SUPPORT GROUPS
THAT THE DOCTOR I GO TO IS CONSIDERATE, AS WELL AS ALL OF HIS STAFF.
THE TESTS
WELLNESS CENTER AND HEALTH DEPT
WELLNESS CENTER AND HEALTH DEPT
WIFE
Other (please specify)
AFAN
111
Ryan White Part A HIV/AIDS Targeted Needs Assessment
ALL IN ONE PHARMACY
COMUNITY CENTER
EDUCATION
HUMAN CARE
RYAN WHITE
RYAN WHITE
RYAN WHITE
STAYING BUSY
VISION
112
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Other (please specify)
ADAP
DOCTORS
DOCTOR'S APPOINTMENTS
MEDICADE
NONE ARE DIFFICULT TO ACCESS
NONE ARE DIFFICULT TO ACCESS
NONE ARE DIFFICULT TO ACCESS
NONE ARE DIFFICULT TO ACCESS
NONE ARE DIFFICULT TO ACCESS
NONE ARE DIFFICULT TO ACCESS
Transportation issues and navigating the system were high on the list of difficulties when it
comes to accessing services. Other issues were more specific in relation to insurance problems,
finding a psychiatrist and barriers to accessing vision care.
If any services are difficult for you to access, please tell us more about what makes them so
difficult to below.
Count
Response Text
5
DENTAL
DENTIST CAN NOT GET INT ANYWHERE
APPLIED FOR DENTAL AND ITS HARD TO GET
MEDICAID DOES NOT OFFER DENTAL
HAD TO PAY FOR X RAYS. $4,000. HAS TAKEN A YEAR TO GET DENTAL MEDICAL.
MEDICARE AND MEDICAID DOES NOT COVER MENTAL. SENIOR DIMENSIONS
DOES NOT COVER DENTAL. NO MONEY.
5
DIFFICULTY NAVIGATING THE SYSTEM/STAFF
DIRECTION IS POOR
NO ONE HELPS GET IT FOR ME
IT IS HARD TO UNDERSTAND THE SYSTEM
THE PEOPLE THERE
THE SYSTEM THE WAY ITS SET UP
3
TRANSPORTATION ASSISTANCE/OTHER SUPPORT SERVICES
THEY'VE TOLD ME THAT I DON'T QUALIFY FOR RENT ASSISTANCE SO I DON'T
EVEN THINK IT EXISTS.
IT'S HARD TO GET TO DOCTOR'S APPOINTMENTS BY BUS AND IT'S HARD TO FIND
OUT ABOUT THINGS LIKE FOOD VOUCHERS OR HOUSING ASSISTANCE BECAUSE
IT'S NOT MENTIONED TO ME.
DIFFERENT WAY TO DO BUS PASSES,TRYING TO GET THEM ARE HARD
2
INSURANCE
THE INSURANCE WILL NOT TELL HIM TO GO
COULD NOT FIND DOCTORS THAT WOULD ACCEPT HER INSURANCE
2
CASE MANAGEMENT
DONT HAVE A CASE WORKER/ SOCIAL WORKER
I WAS NOT OFFERED A CASE MANAGER
113
Ryan White Part A HIV/AIDS Targeted Needs Assessment
2
1
1
1
3
WAIT TIMES
TOOK A LONG TIME TO GET ANY APPOINTMENT JUST FOR ASSISTANCE TO GET
MEDS.
TAKES TOO LONG TO ACCESS
PAPERWORK
AFAN MAKES IT DIFFICULT WITH ALL THE PAPERWORK TO GET SOCIAL SERVICES
SUCH AS BUS PASSES, ASSISTANCE WITH HOUSING.
MENTAL HEALTH
HARD TO FIND A PSYCIATRIST
VISION ASSISTANCE
THROUGH COMMUNITY OUTREACH WHEN I TRIED TO ACCESS VISION CARE THEY
TOLD ME THAT THERE WAS NO AGENCY PROVIDING IT FOR RYAN-WHITE
PATIENTS. I WOULD HAVE TO TRANSFER MY PRIMARY DOCTOR AND CASE
WORKER TO A COMPLETELY DIFFERENT CLINIC AND I DIDN'T WANT TO START
OVER WITH ANOTHER AGENCY BECAUSE I LIKE MY DOCTOR AND CASE WORKER.
OTHER
THEY'RE ALL CHALLENGING IN THEIR OWN WAY TO OBTAIN BUT IT'S NO MORE
DIFFICULT FOR ME THAN FOR ANY OTHER PERSON.
I DON'T ACCESS ANY OF THESE EXTRA SERVICES. I JUST GO TO THE DOCTOR,
MEDICAID PAYS FOR EVERYTHING, AND I EXERCISE. THAT'S IT.
HEALTH DEPARTMENT CALL AND NURSE
Again, family and friends were among the most important people encouraging respondents to
get back into care.
Overall, what is the most important person, place, or thing that helped get you back to
seeing an HIV medical doctor?
Count
Response Text
PERSON
9
MYSELF
4
FRIEND
2
CASE MANAGER
2
HUSBAND
2
MY PARTNER
BOYFRIEND
CHILDREN
EVE ADAMS
FAMILY
HEALTH DISTRICT- CASE WORKER
MY FRIENDS AND FAMILY.
MY KIDS.
MY MOM.
MY ROOMMATE.
MY SON
MYSELF (FOR MY HEALTH AND WELL-BEING)
NURSE MANAGER AT THE SOUTHERN NEVADA HEALTH DISTRICT
SON
114
Ryan White Part A HIV/AIDS Targeted Needs Assessment
SUPPORT OF FRIENDS/FAMILY
UR PARTNER
WILLIAMS AT THE WELLNESS CENTER
PLACE
CDC
WELLNESS CENTER AT UMC
HEALTH DEPT
SOUTHERN NEVADA HEALTH DISTRICT
THING
AFFORDABILITY
EDUCATION
FOOD BANK/FOOD VOUCHERS
HEALTH
HEALTH. WANTING TO LIVE
MY INSURANCE.
MY MOUTH (DENTAL CARE)
THE MEDICATION
THOUGHT OF BEING SICK
WANTED TO STAY HEALTHY
The majority ranked family again as number one with regard to keeping them in care along with
“myself” and their health.
Overall, what is the most important person, place, or thing that helps keep you going to an
HIV medical doctor?
Count
Response Text
PERSON
10
MYSELF
2
MY FRIENDS, FAMILY, AND MY DOCTOR.
CASE MANAGER
CHILDREN
COMBINATION OF MYSELF, FRIENDS/FAMILY, AND NURSE.
DOCTOR
FAMILY
FAMILY AND FRIENDS
FRIEND
GOD
HUSBAND
ME AND MY MOTHER
MY FAMILY
MY GRANDCHILDREN.
MY KIDS.
MY MOM AND MY DAUGHTER.
MY PARTNER
MY SON
MYSELF I WANT TO BE HEALTHY
PARTNER
115
Ryan White Part A HIV/AIDS Targeted Needs Assessment
PEOPLE AT SOUTHERN HEALTH DIST
SAME CASE WORKERS
THE DOCTORS
PLACE
EDUCATION CENTER IT IS THE HEART FOR ME
THING
FOOD BANK/FOOD VOUCHERS
REQUIRES ME TO LEAVE THE HOUSE AND SOCIAL
MY INSURANCE.
WANT TO FEEL BETTER
WANTING TO LIVE FOR FAMILY
GETTING MEDICATION
HEALTH
HUMAN CARE
PROLONGING MY OWN LIFE, I WANT TO LIVE.
READY TO GET THE MEDICATION
OVER ALL HEALTH
TEST AND T CELLS
Many of the additional comments listed below are positive but a lot of the same issues are
reflected here such as; wait times, navigating the system and understanding the care process.
What other comments or information would you like to share?
DENTAL CARE NEEDS TO BE PROVIDED MORE OFTEN. IT’S REALLY HARD TO GET DENTAL CARE
IN NEVADA. AT $13,000 A YEAR THAT'S TOO MUCH TO QUALIFY FOR MEDICAID DENTAL. A
BIG PROBLEM.
GREAT HIV CARE IN THE STATE. WELLNESS CENTER WENT DOWN HILL NOW FEEL BETTER NOT
GOING THERE
HARD TO GET APPTS
LAS VEGAS I WISHED WE COULD WORK TOGETHER IN A GROUP
RYAN WHITE IS A BLESSING THEY ARE GREAT PEOPLE FOR THE HIV/AIDS COMUNITY
SINCE THE MED I HAVE BEEN DEPENDABLE AND I DONT THINK ABOUT IT ANYMORE
THANK GOD FOR RYAN WHITE AND THE AGENCIES THAT HELP PEOPLE THAT NEED HELP.
THANK YOU FOR THE HELP.
THANK YOU RYAN WHITE
THANK YOU VERY MUCH TO THE RYAN-WHITE PERSONNEL FOR HELPING ME RECEIVE THE
SERVICES AND CARE THAT I NEED.
THANKS TO RYAN WHITE I AM RECEIVING TREATMENT. THE MEDICINE IS HELPING. THE
DOCTORS TREAT ME RIGHT.
THE INTERVIEWER WAS VERY HELPFUL AND PATIENT DURING THE SURVEY, THANK YOU.
THERE SHOULD BE BETTER WAYS TO GET RESOURCES. ALSO QUICKER FEEDBACK ON
APPLICATIONS/PAPER WORK
VERY HAPPY ABOUT BEING TREATED WITH CARE
116
Ryan White Part A HIV/AIDS Targeted Needs Assessment
117
WE SHOULD KNOW ABOUT THESE PROGRAMS SO WE CAN GET MORE HELP AND ASSISTANCE
FOR THESE THINGS. WE NEED TO HAVE MORE KNOWLEDGE ABOUT WHAT'S AVAILABLE TO
US.
WHEN FIRST DIAGNOSISED IT WAS VERY EASY. IT’S SO HARD TO KEEP MEDICAL AND
MEDICATION NOW. PROCESSES AND LAWS MAKE IT DIFFICULT.
Comparative Analysis
Several questions regarding services and their importance were identical among the three
survey instruments so that the needs of each sub-population could be compared. When each
group was asked about the ONE service that helps them stay in care, the top responses were;
1.
2.
3.
4.
HIV/AIDS medication
Case management/social worker
Eligibility services
Nurse case managers at the Southern Nevada Health District (primarily to newly
diagnosed and recently returned to care populations)
5. Mental health care
What ONE service helps to keep you in HIV medical care at this time?
Answer Options
Case
management/Social
Worker
Nurse case
managers at the
Southern Nevada
Health District
Dental care
Mental health care
Substance abuse
treatment
Food bank/food
vouchers
HIV/AIDS medication
Emergency financial
assistance (with
utilities and housing)
Medical nutrition
therapy (meeting
with a dietitian)
Housing assistance
(short term
assistance with
housing or referrals
for available
housing)
Newly
Diagnosed
Response
Percent
Newly
Diagnosed
Response
Count
Recently
Relocated
Response
Percent
Recently
Relocated
Response
Count
Returned
to Care
Response
Percent
Returned
to Care
Response
Count
12.3%
10
20.4%
10
8.2%
4
Total
24
6.2%
5
0.0%
0
6.1%
3
0.0%
3.7%
0
3
0.0%
2.0%
0
1
2.0%
4.1%
1
2
0.0%
0
0.0%
0
2.0%
1
0.0%
0
2.0%
1
2.0%
1
25.9%
21
36.7%
18
24.5%
12
0.0%
0
2.0%
1
0.0%
0
8
1
6
1
2
51
1
0.0%
0
0.0%
0
0.0%
0
0
0.0%
0
2.0%
1
0.0%
0
1
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Medical
Transportation (bus
passes)
Assistance with
health insurance copayments and
premiums
Child care services
Legal services (such
as living will)
Language
interpretation
services
Eligibility services
Health education
and risk reduction
classes (Health
Relationships or
Mothers, Sisters,
Daughters)
Peer navigators
Don't know
Prefer not to answer
Other (please
specify)
1.2%
1
0.0%
0
2.0%
118
1
2
1.2%
1
2.0%
1
2.0%
1
0.0%
0
0.0%
0
0.0%
0
0.0%
0
0.0%
0
0.0%
0
0.0%
0
0.0%
0
0.0%
0
7.4%
6
2.0%
1
4.1%
2
0.0%
0
0.0%
0
0.0%
0
1.2%
1.2%
0.0%
1
1
0
0.0%
0.0%
0.0%
0
0
0
0.0%
4.1%
0.0%
0
2
0
39.5%
32
42.9%
21
38.8%
19
3
0
0
0
9
0
1
3
0
72
When asked about the important services that help to keep them healthy overall the top
choices were;
1.
2.
3.
4.
5.
HIV/AIDS medication
Medical care
Case management
Eligibility services
Dental care
What are important services that help keep you healthy overall? (select all that apply)
Answer Options
Case management
Dental care
Mental health care
Substance abuse
treatment
Food bank/food
vouchers
HIV/AIDS medication
Newly
Diagnosed
Response
Percent
Newly
Diagnosed
Response
Count
Recently
Relocated
Response
Percent
Recently
Relocated
Response
Count
Returned
to Care
Response
Percent
Returned
to Care
Response
Count
55.6%
37.0%
24.7%
45
30
20
38.8%
14.3%
12.2%
19
7
6
26.0%
18.0%
14.0%
13
9
7
6.2%
5
2.0%
1
2.0%
1
24.7%
20
24.5%
12
12.0%
6
87.7%
71
81.6%
40
78.0%
39
Total
77
46
33
7
38
150
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Emergency financial
assistance (with utilities
and housing)
Medical nutrition
therapy (meeting with a
dietitian)
Housing assistance
(short term assistance
with housing or referrals
for available housing)
Medical Transportation
(bus passes)
Assistance with health
insurance co-payments
and premiums
Child care services
Legal services (such as
living will)
Language interpretation
services
Medical care
Eligibility services
Health education/risk
reduction classes
(Health Relationships or
Mothers, Sisters,
Daughters)
Support groups
Don't know
Prefer not to answer
Other (please specify)
14.8%
12
8.2%
4
2.0%
119
1
17
18.5%
15
4.1%
2
6.0%
3
20
9.9%
8
8.2%
4
2.0%
1
13
18.5%
15
6.1%
3
6.0%
3
28.4%
23
12.2%
6
8.0%
4
2.5%
2
0.0%
0
0.0%
0
4.9%
4
0.0%
0
0.0%
0
7.4%
6
2.0%
1
0.0%
0
82.7%
45.7%
67
37
69.4%
12.2%
34
6
46.0%
18.0%
23
9
16.0%
13
2.0%
1
6.0%
3
13.6%
0.0%
0.0%
19.8%
11
0
0
16
4.1%
0.0%
0.0%
14.3%
2
0
0
7
2.0%
0.0%
0.0%
20.0%
1
0
0
10
21
33
2
4
7
124
52
17
14
0
0
33
When asked about difficulty accessing services the top responses were;
1.
2.
3.
4.
Dental care
Mental health care
Medical transportation
Was a tie between
a. Emergency Financial Assistance
b. Medical care
c. Vision care
Are any of the following services difficult for you to access? (select all that apply)
Answer Options
Case management
Dental care
Mental health care
Newly
Diagnosed
Response
Percent
Newly
Diagnosed
Response
Count
Recently
Relocated
Response
Percent
Recently
Relocated
Response
Count
Returned
to Care
Response
Percent
Returned
to Care
Response
Count
Total
0.0%
13.4%
6.0%
0
9
4
5.0%
15.0%
15.0%
1
3
3
12.5%
31.3%
9.4%
4
10
3
5
22
10
Ryan White Part A HIV/AIDS Targeted Needs Assessment
Substance abuse treatment
Food bank/food vouchers
HIV/AIDS medication
Emergency financial
assistance (with utilities and
housing)
Medical nutrition therapy
(meeting with a dietitian)
Housing assistance (short term
assistance with housing or
referrals for available housing)
Housing assistance (long term
or permanent housing)
Medical transportation (bus
passes)
Medical transportation (gas or
taxi vouchers, van)
Transportation to recreational
activities
Assistance with health
insurance co-pays and
premiums
Child care services
Legal services (such as living
will)
Language interpretation
services
Medical care
Specialty medical care
Vision care
Eligibility services
Health education/risk reduction
classes (Health Relationships
or Mothers, Sisters, Daughters)
Support groups
Don't know
Prefer not to answer
Other (please specify)
Nurse Case Managers at the
SNHD
0.0%
6.0%
4.5%
0
4
3
0.0%
0.0%
15.0%
0
0
3
9.4%
12.5%
3.1%
3
4
1
6.0%
4
0.0%
0
15.6%
5
120
3
8
7
9
3.0%
2
0.0%
0
3.1%
1
6.0%
4
0.0%
0
12.5%
4
3
8
7.5%
5
0.0%
0
12.5%
4
9.0%
6
10.0%
2
15.6%
5
6.0%
4
0.0%
0
9.4%
3
9.0%
6
5.0%
1
3.1%
1
3.0%
2
5.0%
1
6.3%
2
0.0%
0
0.0%
0
0.0%
0
3.0%
2
0.0%
0
3.1%
1
0.0%
0
0.0%
0
3.1%
1
9.0%
7.5%
9.0%
4.5%
6
5
6
3
10.0%
5.0%
5.0%
5.0%
2
1
1
1
3.1%
0.0%
6.3%
0.0%
1
0
2
0
1.5%
1
0.0%
0
0.0%
0
1.5%
3.0%
0.0%
68.7%
1
2
0
46
5.0%
10.0%
0.0%
35.0%
1
2
0
7
3.1%
3.1%
0.0%
31.3%
1
1
0
10
1.49%
1
Key Informant Interviews
From the specific answers provided during the survey a set of questions was constructed and
respondents were called again to participate in a short phone interview for another $10
Walmart gift card. The first set of questions asks the recently relocated population;
1. You rated the HIV care in the Las Vegas Area as "Poor" or "Fair", what happened to
make you feel this way?
2. In your opinion, what can be done to better improve the services and what services
need to be improved?
9
13
7
8
5
0
3
1
9
6
9
4
1
3
5
0
63
Ryan White Part A HIV/AIDS Targeted Needs Assessment
The entirety of these questions can be read in the table below.
As for question one, the majority of respondents stated that the system is inconvenient, too
much paperwork and too many agencies to go back and forth between, especially for those
clients that are employed. Difficulties scheduling appointments with doctors was also noted and
inconsistencies between agencies with regards to paperwork as well as not receiving the full
gamut of services that were discussed with them initially.
With regard to question two, clients suggested improvements such as; having a one stop shop
for services, limiting paperwork, more awareness of services, more support groups and food
banks located in a central region, and more community outreach.
1 I WENT TO UMC AND I WAS DOING OKAY FOR A WHILE THEN I GOT SICK (FLU/COLD) AND
CALLED THE DOCTOR TO GET A PRESCRIPTION BUT NO ONE EVER CALLED ME BACK. THAT
DOCTOR'S OFFICE ALSO NEVER CALLED WALGREENS BACK FOR MY MEDICINE. I CHANGED
DOCTORS. ALSO, THE FACT THAT YOU HAVE TO GO TO 5 DIFFERENT PLACES TO GET THINGS
DONE--ALL YOUR PROGRAMS, HEALTHCARE, ACCESS TO HEALTH, SOCIAL WORKER/CASE
MANAGER (EACH PLACE TAKE CARE OF ONLY SOME PARTS OF RYAN-WHITE) IS VERY
INCONVENIENT.
2 HAVING A ONE STOP SHOP. WHEN I LIVED IN CHCAGO (HOWARD BROWN) THE CASE
MANAGER, DOCTORS, PSYCHIATRISTS/PSYCHOLOGISTS, WALGREENS, TESTING (STD'S),
ASSISTANCE WITH HOUSING (AIDS FOUNDATION), ALL PAPERWORK FOR ALL RYAN-WHITE
PARTS WERE ALL DONE IN ONE PLACE.
1 IT'S JUST REALLY HARD TO GET CARE. I HAVE A JOB AND I DON’T HAVE TIME TO DO ALL
THAT PAPERWORK. IT'S ALMOST IMPOSSIBLE TO GET THINGS DONE.
2 I HAVE TO DO THE PAPERWORK EVERY 6 MONTHS, IT'S VERY DIFFICULT. IT'S TIME
CONSUMING. I HAVE A JOB AND IT'S HARD TO GET AWAY FOR THE APPOINTMENTS AND I
CAN'T GO ON THE WEEKENDS. IT'S ALMOST IMPOSSIBLE FOR ME TO CONTINUE WITH RYANWHITE.
1 BECAUSE I STILL DON’T HAVE A PRIMARY CARE DOCTOR AS OF YET AND I'VE BEEN TO THE
EMERGENCY ROOM TO GET MEDICATION BUT AFTER A WHILE I GOT FRUSTRATED. I DIDN'T
HAVE INSURANCE AT THE TIME OF THE SURVEY AND THAT'S WHY I RATED THE CARE AS POOR
OR FAIR. I'M NOT SAYING ALL CARE IS BAD.
2 IT'S JUST A MATTER OF CONNECTING WITH THE RIGHT PRIMARY CARE PHYSICIANS. I'VE
RECEIVED OTHER SERVICES LIKE ASSISTANCE WITH UTILITY BILLS AND FOOD THROUGH AFAN.
1 THEY'RE VERY HARD TO FIND. THE FIRST PLACE THAT I WENT TO WAS COMMUNITY HEALTH
AND THEY WERE VERY UNORGANIZED. A MONTH AFTER INITIALLY GOING IN I STILL HADN'T
BEEN APPROVED AND THEN IT GOT NASTY WHEN THEY BLAMED ME FOR THE DELAY BECAUSE
THEY SAID I HADN'T PROVIDED THE PROPER DOCUMENTS. THAT WAS MY FIRST EXPERIENCE.
COMPARISON: I WENT RIGHT NEXT DOOR TO AFAN, TOOK IN MY DOCUMENTS, AND I WAS
APPROVED THAT SAME DAY.
2 WHAT I'M USING PART A FOR IS INDIVIDUAL THERAPY AND DENTAL CARE. THOSE HAVE
BEEN EXCELLENT, SO I WOULDN'T REALLY SAY THERE NEEDS TO BE IMPROVEMENT. WHAT
WOULD BE EASIER WOULD BE TO HAVE MORE AGENCIES AVAILABLE TO ENROLL YOU IN PART
A. I HAVEN'T REALLY RESEARCHED, THOUGH, SO I MAY NOT BE AWARE OF OTHER AGENCIES.
MORE OUTREACH ALSO NEEDS TO BE DONE--ANYTHING RELATED WITH HIV IN LAS VEGAS IS
LOCKED AWAY AND YOU REALLY HAVE TO LOOK TO FIND HIV SERVICES.
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1 I THINK THE CARE IS FAIR. I THINK IT'S JUST GETTING SCHEDULED WITH DOCTORS HERE IN
VEGAS THAT'S DIFFICULT. RIGHT NOW I HAD A PROBLEM WITH MY INSURANCE WHERE THEY
CHANGED THEIR POLICIES WITHOUT INFORMING THEIR PATIENTS AND IT AFFECTS ME WITH
MY MEDICATIONS.
2 THE SERVICES ARE OKAY. IT JUST SO HAPPENS THAT THERE'S NOT A LOT OF DOCTORS AND
WHEN OBAMA CARE KICKED IN IT BECAME CONFUSING. IT WILL TAKE TIME FOR PEOPLE TO
GET USED TO IT.
1 IT'S NOT THAT THE HIV CARE IS BAD BUT BECAUSE OF PAPERWORK IT'S BEEN MORE THAN A
MONTH SINCE I'VE BEEN WITHOUT MEDICATION. NOW THAT I'VE BEEN OUT OF TREATMENT
I'LL HAVE TO START FROM THE BEGINNING WITH A DIFFERENT TREATMENT. PART A PAYS
FOR TREATMENT AND DOCTOR APPOINTMENTS, THEY ALSO PAID MY BUS FARE TO GO TO
NEBRASKA (I'M CURRENTLY IN NEBRASKA BUT WILL BE BACK TO LAS VEGAS), AND THIS PART
IS FAST TO GET. PART B IS WHAT'S CAUSING ME PROBLEMS. I SEE THAT WITH PLAN B, EVEN
IF FELLOW IMMIGRANTS (FROM MEXICO AND CENTRAL AMERICA--I'M CUBAN) HAVE PAPERS,
THEY STILL DON'T GET THE MEDICATIONS THEY NEED AND ARE ALWAYS IN THE HOSPITAL.
PLAN B NEEDS RESTRUCTURING.
2 THERE NEEDS TO BE MORE SUPPORT GROUPS FOR HIV PATIENTS. ST. TERESE'S FOOD BANK
IS ALSO A BIG HELP BUT I HAVE TO TRAVEL FAR TO GET THERE BECAUSE IT'S IN HENDERSON.
IF THEY HAD A FOOD BANK CLOSER TO ME, IN LAS VEGAS, THAT WOULD BE A BIG HELP.
1 BECAUSE OF THE SERVICE THAT I GOT AT AID FOR AIDS OR AFAN. I FELT DISCRIMINATED.
THE FIRST TIME I WENT AN INTERN OFFERED ME A LOT OF SERVICES AND SHE GOT ME INTO
UNLV DENTAL SCHOOL FOR DENTAL WORK (FREE OF CHARGE WITH RYAN WHITE) BUT AFAN
DIDN'T CALL ME BACK ABOUT VISION CARE. I WENT BACK ANOTHER TIME BUT A LADY THERE
WAS TURNING PEOPLE AWAY AND I FELT BAD. ALL I RECEIVED WERE BUS PASSES BUT I HAVE
A CAR, SO I TURNED THEM AWAY. I'M FROM CALIFORNIA AND AT AID FOR AIDS THEY BEG TO
HELP US BUT HERE I DIDN'T RECIEVE THE SERVICES I WAS FIRST TOLD I WOULD GET. THE
SERVICES IN CALIFORNIA ARE ALSO CENTRALLY LOCATED: THERE WAS A SOCIAL WORKER AND
CASE MANAGER AT MY DOCTOR'S AND THEY HAD EVERYTHING. HERE I HAVE TO GO TO
DIFFERENT PLACES TO GET DIFFERENT THINGS, LIKE MEDICATION, DOCTOR, CASE
MANAGEMENT.
2 SERVICES SHOULD BE CENTRALLY LOCATED. AFAN IS GOVERNMENT FUNDED SO I DON'T
UNDERSTAND WHY THE SERVICES AREN'T BEING RECEIVED BY PATIENTS. I JUST FELT
DISCRIMINATION, OR MAYBE THEY DON'T HAVE ENOUGH PEOPLE WORKING THE OFFICE. I'M
NOT THE FIRST ONE UNHAPPY WITH AFAN. MY MAIN COMPLAINT WITH AFAN: SOMEONE
NEEDS TO CHECK OUT AFAN AND THEIR FUNDING SO THEY CAN HELP PEOPLE LIKE THEY SAID
THEY WOULD. ANOTHER THING IS OUT REACH IN THE COMMUNITY (BACK IN CALIFORNIA
EVERYONE KNEW ABOUT AID FOR AIDS) BECAUSE OUT HERE YOU DON'T KNOW WHERE TO
GO FOR SERVICES. ADVERTISEMENT WITH BILLBOARDS OR PAMPHLETS, LIKE IN CALIFORNIA.
THEY NEED TO REACH OUT MORE TO MINORITIES, WOMEN, AND THE GAY COMMUNITY IN
PLACES LIKE CHURCHES.
The recently relocated population was also asked;
1. You rated the HIV care where you used to live before moving to Las Vegas as
"Excellent", what did they do there that made you feel it was "Excellent"?
2. Do they do any of those things here when you receive care?
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Respondents indicated the need for things such as; anal pap smears, a centrally located services
office, and more genuine care and follow-up.
1 THEY DO THINGS THERE (ANAL PAP SMEAR--TO CHECK FOR CANCER OF THE RECTUM) THAT
THEY DON’T DO HERE (PEOPLE HAVE TOLD ME THE CLOSEST PLACE TO GO FOR THIS TEST IS
PALM SPRINGS, CA). I'M UNDER THE IMPRESSION THAT A LOT OF MEN WHO TAKE HIV MEDS
ARE MORE SUSCEPTIBLE TO ANAL CANCER.
2 WHEN I CHANGED DOCTORS HE SEEMED TO BE MORE ATTENTIVE. IN MY HIV SUPPORT
GROUP MANY PEOPLE SAID THEY DON'T EVEN KNOW WHAT AN ANAL PAP SMEAR IS, AND
NEITHER DO THEIR DOCTORS.
1 ALL OF THE HIV CARE WAS HANDLED IN ONE PLACE. ALL RYAN-WHITE AND MEDICAID WAS
HANDLED TOGETHER. IT WAS ONLY A HALF HOUR PROCESS, WHILE HERE IT'S A 5 OR 6 DAY
PROCESS. I HAVE TO MAKE APPOINTMENTS ON DIFFERENT DAYS TO COVER ALL PARTS OF
RYAN-WHTE.
2 NO, IF THEY HAD ALL SERVICES IN ONE BUILDING --APPLY FOR RYAN-WHITE AND GET
TREATMENT IN ONE PLACE WOULD BE ALL GOOD. I'M NOT USING RYAN-WHITE, THOUGH,
BECAUSE RYAN-WHITE IS ONLY MY SECONDARY AND MEDICAID ALREADY COVERS
EVERYTHING, SO I DON'T END UP USING RYAN-WHITE AT ALL. MEDICAID BASICALLY COVERS
EVERYTHING.
1 CONNECTING WITH THE RIGHT PRIMARY CARE PHYSICANS AND EXCELLENT PEOPLE THAT I
WAS ABLE TO OPEN UP TO. I HAD GOTTEN SICK AND I ENDED UP IN THE HOSPITAL WITH
PNEUMONIA FOR 21 DAYS THAT TIME.
2 I WENT TO THE DOCTOR FOR AN ISSUE AND, YES, THEY WERE VERY HELPFUL. THE DOCTORS
THERE WERE EXCELLENT HERE.
1 I WAS ON MEDICARE AND MEDICAL IN CALIFORNIA, NO PRIVATE INSURANCE. WHAT MADE
IT BETTER WAS THAT THE PUBLIC SERVICES ALLOW YOU TO HAVE AN HIV DOCTOR AS YOUR
PRIMARY CARE PHYSICIAN AND CLINICS ARE COMPREHENSIVE WITH ALL SERVICES UNDER
ONE ROOF--DOCTOR/CASE MANAGEMENT/SOCIAL WORKER/RYAN-WHITE--NO NEED TO
SPEND ALL DAY GOING FROM PLACE TO PLACE GETTING THINGS IN ORDER. I DON'T QUALIFY
FOR MEDICAID IN NEVADA SO I'M ON HMO HERE AND THEY WON'T ALLOW YOU TO HAVE AN
HIV CARE SPECIALIST AS A PRIMARY CARE DOCTOR. BASED ON THE FACT THAT I QUALIFIED
FOR MEDICAL IN CALIFORNIA, IT ELIMINATED ALL OF THIS HMO NONSENSE. HMO HAS BEEN
LIKE A LIVING HELL. MOST PEOPLE WITH HMO'S WILL AGREE.
2 NOT THAT I'VE EXPERIENCED. AS I SAID, I'M NOT ALLOWED COMPREHENSIVE CARE
BECAUSE OF MY HMO.
1 EVERYTHING THEY DID WAS RIGHT ON POINT. THEY DIDN'T MISS A BEAT, KEPT IN CONTACT
AND I HAD THEIR NUMBERS TO REACH THEM DIRECTLY. THEY BECAME ALMOST FAMILY.
2 THEY'RE PRETTY GOOD HERE. SO FAR, SO GOOD. THE SOCIAL WORKER, HIV DOCTOR (SHE
HANDLES EVERYTHING AND IS MY PRIMARY CARE PHYSICIAN AS WELL), AND MEDICATIONS.
1 LOCATED IN ONE BUILDING. DIDN’T HAVE TO TRAVEL. SAVED TIME AND MADE IT EASIER.
2 NO HAVE TO GO TO DIFFERENT LOCATIONS AND IT MAKES IT LONG AND DIFFICULT.
1 THEY TOOK VERY GOOD CARE OF ME, THEY ATTENDED MY EVERY NEED, THEY ANSWERED
EVERY QUESTION. THEY WERE LIKE FAMILY AND MADE YOU FELE LIKE THEY GENUINELY HAD
AN INTEREST IN YOUR WELL-BEING.
2 I FEEL IT'S PRETTY MUCH THE SAME TYPE OF ATTENTIVE CARE I RECEIVE HERE. I LIVED IN A
SMALL FAMRMING COMMUNITY BEFORE BUT THE CARE HERE IS EXCEPTIONAL AS WELL, JUST
A LITTLE BUSIER BECAUSE IT'S A LARGE CITY, BUT THAT'S UNDERSTANDABLE.
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1 THEY TOOK CARE OF EVERYTHING: MEDICATIONS, BLOOD WORK, ETC. EVERYTHING I
NEEDED THEY GOT DONE QUICKLY AND EFFICIENTLY.
2 LAS VEGAS IS 10 TIMES BETTER: PROVIDING FOOD, PAYING FOR MEDICATIONS AND BLOOD
WORK. I ALSO RECEIVE MENTAL HEALTH CARE.
1 THEY PROVIDED GOOD CUSTOMER SERVICE AND THEY MADE SURE THAT I TOOK THE
MEDICATIONS ON A REGULAR BASIS.
2 YES. VERY GOOD STAFF. IF I NEED HELP THEY HELP ME. THEY'RE GOOD AT CALLING THE
PATIENTS BACK AND I'M VERY HAPPY WITH THE SERVICE IN LAS VEGAS.
1 THEY GOT TO ME RIGHT AWAY.
2 HERE THEY WERE ALSO QUICK TO GET ME IN TO HIV CARE, AS WELL.
1 THE DOCTOR HIMSELF. THEY MADE YOU FEEL LIKE A HUMAN BEING AND WERE
COMPASSIONATE. THEY HAD HUMAN TOUCH. THE DOCTOR IN OMAHA HUGGED YOU WHEN
YOU CAME INTO THE ROOM AND PHYSICALLY TOUCHED YOU AND MADE YOU FEEL CARED
ABOUT. SOME DOCTORS DON'T PHYSICALLY TOUCH YOU AND HOW CAN THEY CARE FOR YOU
IF THEY WON'T TOUCH YOU.
2 THE CARE HERE WAS SKETCHY AT BEST. I'VE SEEN ONE DOCTOR HERE DIDN'T SEEM
PRESENT AT ALL (ABSENT-MINDED).
1 JUST THE FOLLOW UP CARE AND THE OFFICE STAFF WERE VERY PERSONABLE. WE WERE
KEPT ON A REGUALR SCHEDULE AND THE DOCTOR WAS ON THE BALL WITH EVERYTHING.
OVERALL, REALLY GREAT.
2 YES, I CAN COMPARE THE TWO AND HERE THEY'RE GREAT, VERY EFFICIENT. I WOULD
PREFER A DOCTOR TO A NURSE PRACTIONER DURING CONSULTATION BUT I'M HEALTHY SO
THEY ARE TAKING GOOD CARE OF ME. THE ELIGIBILTY COORDINATOR AND STAFF ARE A
DELIGHT.
The newly diagnosed group was asked;
1. After you were first diagnosed you said that you didn't receive all the services and
assistance you needed to see a doctor for your HIV status. What could have been done
to better assist you, or what do you feel was missing from the experience?
Only one respondent participated in this question and had issues regarding blood work.
BASICALLY, LIKE I SAID LAST TIME, WHAT WAS MISSING WAS COMPETENCE BY THE UMC PEOPLE
BECAUSE THE NEXT STEP WAS FOR ME TO DO BLOOD WORK TO DIAGNOSE THE GENOME IN MY
SYSTEM SO THEY COULD PRESCRIBE MEDICATION. AFTER DOING BLOOD WORK THE FIRST TIME,
I WAITED 2 MONTHS FOR THEM (AT UMC) TO SAY THAT THEY COULDN'T ANALYZE MY BLOOD
FOR X OR Y REASON AND THE WORK WASN'T DONE RIGHT. WHY DID THEY NOT CALL ME RIGHT
AWAY? I WENT IN AGAIN AND THEN TOOK BLOOD AND I WAITED ANOTHER 2 MONTHS ONLY
TO HEAR THAT THEY HAD MESSED UP AGAIN. RYAN -WHITE PAID FOR THE BLOOD WORK
ANALYSIS, SO THEY BASICALLY PAID FOR INCOMPETENCE. I ULTIMATELY GAVE UP AFTER THOSE
TWO TIMES BECAUSE THERE WAS NO ONE ELSE I COULD TALK TO ABOUT THIS ISSUE, I FELT,
AND NO ONE THAT COULD HELP ME SOLVE THAT ISSUE. I WILL DO IT ALL ON MY OWN ONCE I
GET SOME KIND OF INSURANCE.
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The returned to care group was asked;
1. You reported that you were first diagnosed in an Emergency Room/Hospital setting.
After they told you about your diagnosis did they help you get into HIV medical care, did
a case manager meet with you and help you set up appointments for HIV care while you
were still in the hospital?
2. What hospital were you diagnosed at?
Unfortunately these participants weren’t directly linked with medical care at the time of
diagnosis but were provided with some information and medication.
1 YES, I HAD SOME HELP. THEY TOLD ME WHERE TO GO. I HAD AN EATING DISORDER AND
AFTER GETTING THROUGH IT I WAS DIAGNOSED WITH HIV. MY T-CELLS WERE DOWN TO
THREE AND MY IMMUNITY WAS REALLY LOW. I HAD MALNUTRITION DUE TO MY EATING
DISORDER SO I WAS IN PRETTY BAD SHAPE. I TRULY BELIEVE THAT RYAN-WHITE AND THE
GOVERNMENT SHOULD BE BEHIND A LAW THAT WOULD FACILITATE THE PROTECTION OF
PARTNERS IN COMMITTED RELATIONSHIPS. IF THE GOVERNMENT COULD FUND THE
PROGRAM "PREP" NATIONWIDE TO PROVIDE THE BLUE PILL (GIRADA?) THAT PROTECTS
PARTNERS OF THOSE INFECTED WITH HIV SO THAT THEY DON'T CONTRACT HIV. THE CLINIC
HERE IN LAS VEGAS USED TO BE MORE JUDGEMENTAL BUT NOW IT'S DIFFERENT. OUTREACH
SHOULD BE DONE IN A KIND WAY, NOT SO MUCH A MEDICAL WAY.
2 LINCOLN ROAD HOSPITAL OR SOUTH BEACH GENERAL HOSPITAL IN SOUTH BEACH MIAMI,
FLORIDA.
1 NO, THEY JUST GAVE ME A BUNCH OF MEDICINE AND SENT ME HOME. I HAD TO FIND A
DOCTOR ON MY OWN.
2 UMC (I WENT TO NORTH VISTA FIRST BUT THEY DIDN'T KNOW WHAT WAS WRONG WITH
ME).
1 THEY DIDN'T HELP ME SET UP ANY APPOINTMENTS, BUT THEY DID GIVE ME INFORMATION
AS TO WHERE TO GO.
2 UMC
1 YES, BUT I WAS A CHILD. I WAS A GUINEA PIG FOR MEDICATIONS AND TREATMENTS.
2 UCLA HOSPITAL
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