Presentation Transcript
Review of theMedical Monitoring Project Outcomes of InterestPilot Year Data: Review of the Medical Monitoring Project Outcomes of Interest Pilot Year Data
MMP PAB/CAB Meeting
May 31, 2007
Department of State Health Services
Epidemiology andamp; Surveillance Unit
Sylvia L. Odem, MPH
Project Coordinator
Acknowledgements to the Pilot Year TX-MMP Team:: Acknowledgements to the Pilot Year TX-MMP Team:
Katharine Carvelli, Epidemiologist
Mark Heinzke, Data Manager
Sharon K. Melville, Principal Investigator
Nita Ngo, Epidemiologist
Jim Phillips, Data Collector
Renee Ridgley, Data Collector
Tammy Sajak, Co-Principal Investigator
Jose Velez, Data Collector
Simone Wooden-Jackson, Data Collector
What is the Medical Monitoring Project (MMP)?: What is the Medical Monitoring Project (MMP)? A survey and medical chart review about the experiences and needs of people living with HIV and AIDS in the US
Behaviors
Clinical outcomes
Type and quality of care received
Identify met and unmet needs for HIV care and prevention services
MMP Goals: MMP Goals Determine access to and use of prevention and support services
Provide local and national estimates for the population in care for HIV
Examine variations of factors by geographic area and patient characteristics (i.e. risk behaviors, quality of care etc.)
How you might use the MMP data : How you might use the MMP data Supplement your local needs assessments
Determine need for new programs in your organization
Use for grant applications and RFP’s
Use as a benchmark for your programs
Requests for special data runs
Nationally Representative Three Stage Sampling Design: Nationally Representative Three Stage Sampling Design 1st stage - Site
20 states + 6 cities randomly selected
2nd stage - Provider
40-60 facilities randomly selected - large, medium, and small
3rd stage - Patient
400 randomly selected patients High Medium Low LA County Alaska Hawaii Puerto Rico New York City San Francisco Houston Chicago Philadelphia
MMP Success: MMP Success
MMP Data collection: MMP Data collection Pilot Year – 2005
Preliminary data
13 sites
Sampled 27 facilities
Sampled 150 patients
81 interviews
86 chart abstractions Project Year – 2007
Full year – all 26 sites participating
Sampled 47 facilities
27 recruited to-date
400 patients to be sampled
400 interviews andamp; abstractions to be done
Demographics & Patient Characteristics: Demographics andamp; Patient Characteristics
Gender: Gender
Race/Ethnicity: Race/Ethnicity
Age by Race: Age by Race
Age by Race: Age by Race (14%) (21%) (48%) (18%)
Education by Race: Education by Race *Cell suppressed for nandlt;3
Age First Positive by Race: Age First Positive by Race (44%) (40%) (15%) (1%)
Number of Years HIV Positive: Number of Years HIV Positive n=25 n=22 n=12 n=13 * *Cell suppressed for nandlt;3
Alcohol and Drug Use: Alcohol and Drug Use n=46 n=21
Date of Last Injection and First Positive Date: Date of Last Injection and First Positive Date
Frequency of Alcohol Consumption in Past 12 Months*: Frequency of Alcohol Consumption in Past 12 Months* *51% of those interviewed reported alcohol use in the past 12 months
No. of Alcoholic Drinks in Typical Day in Past 30 Days: No. of Alcoholic Drinks in Typical Day in Past 30 Days
Drug Use in Past 12 months: Drug Use in Past 12 months *Embalming fluid
Mean Number of Sexual Partners in the Past 12 months: Mean Number of Sexual Partners in the Past 12 months
Male: Male Partner(s): Male: Male Partner(s) 64% of men interviewed reported having male sexual partner(s) in the past 12 months *Among men who reported having anal sex in past 12 months
Male: Male Partner(s) – Last Time You Had Sex: Male: Male Partner(s) – Last Time You Had Sex
Male: Female Partner(s): Male: Female Partner(s) 10% (n=7) of men interviewed reported having female sexual partner(s) in the past 12 months
*Cell suppressed for nandlt;3
Female: Male Partner(s): Female: Male Partner(s) 46% (n=6) of women had male sexual partner(s) in the past 12 months *Cell suppressed for nandlt;3
Access to Care & Need for Services: Access to Care andamp; Need for Services
Public Assistance and Homelessness in Past 12 Months: Public Assistance and Homelessness in Past 12 Months n=7 n=45 *57% (n=4) of homeless were receiving public assistance
Health Insurance Coverage: Health Insurance Coverage
Payment Method for HIV Meds & Other Meds in Past 12 Months: Payment Method for HIV Meds andamp; Other Meds in Past 12 Months
Time to Start HIV Care: Time to Start HIV Care
Reasons for Delay in HIV Care: Reasons for Delay in HIV Care Didn’t want to think about being HIV positive (main reason)
Felt good, didn’t need to go
Too busy to go
Didn’t want to believe HIV test results
Drinking or using drugs
Fear of being socially ostracized
Felt meds were dangerous
Need and Receipt of Services in the Past 12 Months: Need and Receipt of Services in the Past 12 Months
Reasons for Not Receiving Services Needed: Reasons for Not Receiving Services Needed Didn’t know where to go/who to call (n=12)
Service not available in patient’s area (n=4)
Waiting list too long (n=7)
Transportation problems (n=*)
Not eligible or denied services (n=*)
Services too costly (n=*) *Cell suppressed for nandlt;3
Receipt of Prevention Activity Itemsin Past 12 Months: Receipt of Prevention Activity Items in Past 12 Months *Percentage computed using those who had received condoms as the denominator
†25% reported ever injecting drugs, but 0% have injected drugs in the past 12 months
Free Condom Source: Free Condom Source
Preventive Therapies and Screenings: Preventive Therapies and Screenings
Preventive Therapy: Preventive Therapy *Only prescribed to patients who have a CD4 cell count andlt;49.
Reasons For Not Receiving Hepatitis Vaccination: Reasons For Not Receiving Hepatitis Vaccination
Patient already has hepatitis
Doctor indicated vaccine not necessary
Patient did not believe they were at risk for contracting hepatitis
Patient doesn’t like needles
Patient was not aware vaccine was available
Patient did not complete the series
Ever Tested for and Ever Had Hepatitis: Ever Tested for and Ever Had Hepatitis
Prevention: Tests: Prevention: Tests †Among patients who have ever had a TB skin test
*Cell suppressed for nandlt;3
STD Screening in Past 12 months: STD Screening in Past 12 months
Female Sexual Health: Female Sexual Health n=13 n=10
Female Sexual Health: Female Sexual Health n=11 n=11 n=5 n=5 n=12 n=12 n=5 n=5 *Among patients who ever had a PAP smear
Facility Type for Last Pelvic Exam: Facility Type for Last Pelvic Exam
CD4, Viral Load Tests & ARV Medications: CD4, Viral Load Tests andamp; ARV Medications
CD4 and Viral Load Tests in Past 12 Months: CD4 and Viral Load Tests in Past 12 Months
Antiretroviral Usage: Antiretroviral Usage n=76 n=63 n=12
Drug Combinations of ARV Meds Currently Using: Drug Combinations of ARV Meds Currently Using *Includes combinations such as 3 nukes and 2 PIs; 3 nukes and 1 non-nuke; 3 nukes, 2 PIs, and 1 combination drug; 2 nukes, 1 PI, and 1 combination drug; 1 nuke, 1 non-nuke, and 1 combination drug
†Including combinations such as 1 nuke and 1 PI; 1 nuke and 1 non-nuke; 1 nuke and 1 combination drug
Reason Never Started Antiretroviral Treatment: Reason Never Started Antiretroviral Treatment Doctor advised to delay treatment (main reason)
CD4 counts and/or viral load good
Felt good and didn’t need them
Concerned about side effects
Reason Not Currently on ARV Meds: Reason Not Currently on ARV Meds Doctor advised to delay treatment
CD4 counts and/or viral load good
Felt good and didn’t need them
Concerned about side effects
Allergic to medicines
Tired of taking medicines
Patient believed medicines complicate his/her life
Last Time Missed Any ARV Dose*: Last Time Missed Any ARV Dose* *Among patients who were currently taking antiretrovirals
Adherence to Medication Instructions in Past 2 Days: Adherence to Medication Instructions in Past 2 Days *Among patients who were currently taking antiretrovirals with special instructions
Reason for Missing Doses of Antiretroviral Meds: Reason for Missing Doses of Antiretroviral Meds
Contact Information: Contact Information
Email: TXMMP@dshs.state.tx.us
Call Sylvia Odem, Project Coordinator at (512) 533-3053
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