PLANNING COMMUNITY-WIDE SERVICES FOR PERSONS WITH HIV-INFECTION IN AN AREA OF MODERATE INCIDENCE

The human immunodeficiency virus (HIV) epidemic has placed enormous strains on health care and social services delivery. The authors studied the response to the epidemic by a local health jurisdiction in an area of moderate incidence. The area recorded about 1,000 cumulative cases of acquired immunodeficiency virus syndrome, and the estimated prevalence of HIV infection was 10,000 as of 1991. The local health jurisdiction combined methods in a community-wide planning process for HIV services. The process mobilized the existing community-based network of service providers to identify problem areas and to develop recommendations for action. The planning group used questionnaires and service use rates to project service requirements, estimate service availability, and establish levels of unmet needs in terms of units of service. Annual requirements per person with HIV infection were projected for case management (0.3 to 0.4 client enrollment slots), dental care (1.9 to 3.4 visits), nonacute institutional care (1.2 days), home health care (17.8 to 22.1 visits), short-term housing (8.3 to 10.6 days), mental health and emotional support (34.6 to 36.6 visits), legal services (2.7 appointments), acute inpatient medical care (2.0 to 3.2 days), and inpatient psychiatric care (0.2 to 0.3 days). Those service requirement estimates for a low or moderate HIV incidence area may be transferable to other communities.