# Unmet Needs for Ancillary Services by Provider Type Among People With Diagnosed Human Immunodeficiency Virus

## TL;DR

People with HIV often have unmet needs for support services, and the type of healthcare provider they see affects which services are unmet.

## Contribution

This study identifies disparities in unmet ancillary service needs among PWH based on provider type, revealing specific areas needing improvement.

## Key findings

- 98.2% of PWH reported needing at least one ancillary service, with 46% having at least one unmet need.
- Patients of non-ID physicians had fewer unmet dental care needs compared to those of ID physicians.
- Patients of nurse practitioners had fewer unmet HIV case management needs compared to those of ID physicians.

## Abstract

Unmet needs for ancillary services are substantial among people with human immunodeficiency virus (PWH), and provider type could influence the prevalence of unmet needs for these services.

Data from a national probability sample of PWH were analyzed from the Centers for Disease Control and Prevention’s Medical Monitoring Project. We analyzed 2019 data on people who had ≥1 encounter with a human immunodeficiency virus (HIV) care provider (N = 3413) and their care facilities. We assessed the proportion of needs that were unmet for individual ancillary services, overall and by HIV care provider type, including infectious disease (ID) physicians, non-ID physicians, nurse practitioners, and physician assistants. We calculated prevalence differences (PDs) with predicted marginal means to assess differences between groups.

An estimated 98.2% of patients reported ≥1 need for an ancillary service, and of those 46% had ≥1 unmet need. Compared with patients of ID physicians, needs for many ancillary services were higher among patients of other provider types. However, even after adjustment, patients of non-ID physicians had lower unmet needs for dental care (adjusted PD, −5.6 [95% confidence interval {CI}, −9.9 to −1.3]), and patients of nurse practitioners had lower unmet needs for HIV case management services (adjusted PD, −5.4 [95% CI, −9.4 to −1.4]), compared with patients of ID physicians.

Although needs were greater among patients of providers other than ID physicians, many of these needs may be met by existing support systems at HIV care facilities. However, additional resources may be needed to address unmet needs for dental care and HIV case management among patients of ID physicians.

Unmet needs for most ancillary services were comparable among all provider types. However, additional resources may be needed to address remaining disparities in unmet needs for dental care and HIV case management among patients of infectious diseases physicians.