Médecine communautaire et éducation à la santé

Abstrait

Structural Characteristics of Local Health Departments Providing HIV/AIDS Services

Joseph Smith, Willie H Oglesby and Olivia Hartman

Context: HIV infection causes significant health and economic burdens in communities throughout the United States. Despite the large number of research studies focusing on the effectiveness of HIV screening and treatment, little is known about the role that local health departments (LHDs) play in community-based HIV screening and treatment.
Objective: In order to better understand HIV screening and treatment activities of LHDs in the US, we examined the structural characteristics of LHDs that do and do not provide these services.
Design: This was a cross-sectional study using data from the 2010 National Profile of Local Health Departments. Using regression modeling, we examined the relationship between the provision of HIV screening and/or treatment and various structural characteristics of LHDs.
Results: Over two-thirds of LHDs that responded to the survey reported providing HIV screening, and just under one-third (33%) of LHDs provided HIV treatment. LHDs that provided HIV screening and treatment were more likely to be engaged in other community-based activities and provide a broad range of services. In addition, they were significantly more likely to have public practitioners such as public health managers, physicians, epidemiologists, health educators, behavioral health specialists, and public health nurses. These LHDs were also more likely to employ a full time CEO and have a local board of health. Results also indicate that the provision of HIV screening and treatment is likely a function of funding level and size of the population served.
Conclusions: HIV screening and treatment services can have a significant impact on community health and overall healthcare expenditures by reducing infection rates and linking the infected to care. Many LHDs are well positioned to provide these needed services and thus, play a major role in sustaining community health; however, the organizational capacity of LHDs to provide these services must be improved.