Tobacco use presents unique health risks for persons living with HIV/AIDS (PLWHA). There is an urgent need to characterize tobacco use among PLWHA, and to assess the capacity of HIV/AIDS service providers to deliver smoking cessation interventions. Questionnaires were administered to PLWHA in care in New York State (n = 1,094) and to State-funded HIV/AIDS service providers (n = 173) from 2005 to 2007. Current PLWHA smoking prevalence was 59%, three times the general population rate. Over 50% of current smokers were moderately or highly dependent on nicotine. Three-quarters of smokers indicated an interest in quitting, and 64% reported a least one quit attempt during the past year. Less than half of HIV/AIDS service providers reported always assessing tobacco use status, history, dependence, or interest in quitting at intake. Medical care providers were more likely to conduct assessments and provide services. Although 94% of providers indicated a willingness to incorporate tobacco cessation services, 65% perceived client resistance as a barrier to services. HIV/AIDS service providers are inadequately addressing the high smoking rate among PLWHA, despite being uniquely suited to do so. Efforts are needed to educate providers about the need for, and interest in, tobacco cessation.
This article reports on the use of and need for health and human services by community-residing people with dementia. Telephone interviews were conducted with a sample of 608 caregivers of such individuals who were randomly selected from a dementia registry. Caregivers reported using an average of 3.2 health services and 3.7 human services to assist them in the care of the person with dementia. Despite the high level of services use, 73 percent of the caregivers indicated a high need for at least one additional service, and 72 percent indicated that additional services would reduce the likelihood of institutionalization of the recipient. Although services use was more frequent than expected, many caregivers lacked knowledge about services, a fact that suggested that social workers have a vital information and referral role to play.
In the United States, racial/ethnic health disparities persist across all leading health indicators. In 2005, African Americans accounted for half of all HIV/AIDS cases, but only 12 percent of the US population was African American. Since the beginning of the HIV/AIDS epidemic, the New York State Department of Health, AIDS Institute recognized the importance of faith communities' involvement in HIV prevention. A survey assessed faith community involvement in HIV prevention, identified barriers to involvement, and determined willingness to partner with HIV prevention programs. Although less than 25 percent of respondents reported involvement in HIV prevention, 50 percent were willing to meet with service providers. Those willing to meet included 74 percent of faith leaders with primarily African American congregants. On the basis of the survey and subsequent forums, a statewide initiative was created to involve faith communities in HIV prevention. An assessment of the statewide initiative showed that it has been highly effective in engaging faith community involvement, including a large number of African American faith communities. These findings have implications for future programming and can aid to further strengthen the statewide initiative.
As of September 2010, New York State (NYS) Public Health Law mandates the offer of HIV testing to all persons aged 13-64 years receiving hospital or primary care services. Changes in the number of HIV tests 13 months before and after law enactment were assessed using HIV test volume data from 166 laboratories holding NYS permits to conduct HIV testing on specimens originating in NYS. Compared with the pre-enactment baseline, overall HIV testing volume increased by 13% following enactment, with the volume of conventional and rapid HIV screening tests increasing by 12.0% and 13.7%, respectively. These data suggest that testing law is having an impact consistent with the legislative intent to increase HIV testing in NYS. Monitoring should be continued to assess testing trends across a variety of health care venues to identify and address additional barriers to HIV testing access.
This survey examined the extent of HIV prevention interventions available to approximately 70,000 inmates housed in the 69 correctional facilities that comprise New York State's prison system and explored barriers to offering prevention services. Specific HIV prevention interventions were selected. A written survey was used to ascertain their availability within the previous 12-month period at each correctional facility. Correctional facilities reported a high level of availability of HIV prevention interventions and services. All 69 (100%) reported prevention education, and 59 (86%) said they met or exceeded inmate demand. More than 90% reported individual and group counseling and more than three-quarters offered both English and Spanish. Support groups were reported as being offered at 50 (73%) prisons. Significant progress in meeting HIV prevention needs of New York State inmates has been achieved. The Criminal Justice Initiative is a highly effective service delivery model. Efforts to better meet needs of Spanish-speaking inmates should continue.
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