The Bay Area Reporter - July 16, 1999
Cynthia Laird

The council will hear a second presentation at its meeting this Monday, July 12 at the AIDS Office.

The assessment is based on both qualitative data -- gathered from 194 respondents in 22 focus groups -- and quantitative data from 968 PWAs. Both involved clients living in San Francisco and San Mateo counties. The study cost $180,000.

Steve Lew, with the Support Center for Nonprofit Management, presented the qualitative data from the 22 focus groups. Some groups, such as African-Americans and women, were oversampled, while others, most notably youth, were under-represented because only five showed up to the focus group. Harder+Company Community Research prepared the quantitative analysis.

When judged independently of each other, the findings in the two individual analyses don't always match. In the quantitative analysis, for instance, dental services edged out housing as the main unmet need, with 38 percent of the 968 people surveyed, or 177, calling dental services inadequate. Housing was second at 29 percent, or 137 people. Home health care was the third highest unmet need, said Michael DeMayo, senior research associate.

When studied quantitatively, however, housing is easily seen to be the most pressing problem. Among African-Americans survey respondents, 52 percent reported that they are currently homeless. A total of 191 African-Americans, or 44 percent, reported that they are currently on a housing waiting list, and 34 percent reported needing help finding a place to stay in the past four months. Thirteen percent of those respondents received shelter services; 2 percent received permanent housing; 7 percent received assistance locating housing, and 5 percent received transitional housing.

Of those who received services, 15 percent reported that the services they received did not meet their needs, either because the housing was not adequate, they are still homeless, or there are too many limits on assistance.

Study facilitators heard horror stories about single resident occupancy (SRO) hotels, from active drug use in hallways, to cockroach and rat-infested living quarters. For some clients, there's also a difficulty in moving often; because they have no storage facility, they often lose their possessions when they have to move.

Drug use, good and bad

According to the quantitative summary, 63 percent of people with an AIDS diagnosis are currently taking HIV/AIDS medications, although women are less likely to be taking medications than male or transgender clients, DeMayo said.

Lew said that regardless of HIV treatment, clients in the qualitative focus group studies report "doing well," and doing better than previous periods in their infection, and reported strong feelings for their medical providers, "It was overwhelming, in every group, reports of satisfaction with medical care," he said. "Many people 'love' their medical providers."

Most physical problems reported were related to side effects from the new therapies. Lew acknowledged that the focus group results might be skewed because people who were feeling good were able to attend the focus group meetings.

"Most client needs have been met," he said. "There's not a high level of unmet needs. The notable exception is housing."

Employment issues also figured prominently, with clients in the focus groups commenting about their fears of returning to work. The most common obstacle was fear of losing benefits, but clients also mentioned other fears including discrimination and not being able to work a full day.

Another interesting finding from the focus groups was the perception among some heterosexuals and people of color that services were not sensitive enough to them, and geared primarily toward gay men. "Some people of color and heterosexuals perceive some agencies as discriminatory," Lew said, adding that immigrants are less likely to access services because of fears they'll be reported to immigration officials.

Other complaints about ASOs included a lack of respect, a high level of bureaucracy, a lack of cultural diversity among staff, insensitivity to different cultures, turf issues between organizations, a lack of empathy, and slips in confidentiality as their main complaints.

Lew said the clients' feelings are mixed when it comes to Reggie, the city's centralized database for PWAs that some ASOs use, but others haven't started yet. "Some wondered why all agencies aren't on [Reggie], and some providers who are on Reggie aren't using it," Lew said.

The HIV Health Services Planning Council meets Monday, July 12, in room 330A of the AIDS Office, 25 Van Ness Avenue, from 4:30 to 7:30 p.m.
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