Date Presented 03/28/20
OTs are uniquely suited to work with individuals with HIV because of their ability to address complex medical, psychological, and social needs. However, OTs are rarely engaged in community-based HIV services. Using data from a needs assessment of individuals with HIV in Hawaii (n=398), we identify disparities related to disability and offer suggestions on how OTs can support health among this population through community-based practice.
Primary Author and Speaker: Joy Agner
Contributing Authors: John Barile
PURPOSE: Occupational therapists (OTs) are uniquely suited to work with people living with HIV and AIDS (PLWHA) because of their ability to address complex medical, psychological, and social needs. However, occupational therapists are rarely engaged in community-based HIV services in the United States (Bauermeister, Tross, & Ehrhardt, 2009; Braveman, Levin, Kielhofner, & Finlayson, 2006; Salz, 2001) and research in this area is lacking. The purpose of this research is to identify how OTs might contribute to community based HIV care by answering the following questions: 1) what are the most common unmet needs among PLWHA? 2) Are there disparities among PLWHA related to disability (defined as assistance with daily self-care)?
DESIGN: 398 individuals with HIV living in Hawaii were recruited via case management agencies to participate in a needs assessment survey. Anyone with HIV was eligible to participate, although based on the recruitment method, most people who participated were actively engaged in case management.
METHOD: The needs assessment identified barriers to medical care, social determinants of health, and several demographic factors including race, geographic location, age, gender, disability, and income. Results were analyzed using descriptive statistics (to identify overarching needs), and multiple regression (to examine disparities).
RESULTS: Results indicate that the most difficult services to access were dental care, alternative therapy, counseling, enrolling in housing services, and paying for food. People with disabilities had significant disparities compared to the rest of the participants. Individuals who needed assistance with daily self-care (n=55) had greater difficulty paying bills, paying for food, addressing alcohol and drug use, and getting to appointments (p <.05). They were also less likely to be born in the US. (p<.05).
CONCLUSION: These results indicate that PLWHA who have concomitant disabilities have notable disparities that likely impact their health and quality of life. This work contributes to a growing body of literature on disability and HIV (Hanass-Hancock & Nixon, 2009). We argue that occupational therapists can make asignificant contribution to this public health issue through community-based OT services, and more directed research is needed in this area. In conclusion, we describe some strategies that occupational therapists might utilize to increase equitable services among this population.
IMPACT STATEMENT: This research identifies disparities among people with HIV who also require assistance with self-care, and argues that occupational therapist can provide a unique skill set to address this public health issue.
References
Braveman, B., Levin, M., Kielhofner, G., & Finlayson, M. (2006). HIV/AIDS and return to work: A literature review one-decade post-introduction of combination therapy (HAART). Work, 27(3), 295–303.
Hanass-Hancock, J., & Nixon, S. A. (2009). The fields of HIV and disability: Past, present and future. Journal of the International AIDS Society, 12(1), 28. https://doi.org/10.1186/1758-2652-12-28
Salz, F. (2001). HIV/AIDS and work: The implications for occupational therapy. Work, 16(3), 269–272.
