Published January, 2000

Directions in HIV Service Delivery and Care: A Policy Brief: Reducing Barriers to Care, U.S. Health Resources and Services Administration, HIV/AIDS Bureau (2000)

This policy brief publishes the findings of studies undertaken by the federal HIV/AIDS Bureau to understand the factors that affect access to care and ability to remain in care for poor, low-income and traditionally underserved populations.

In particular, the policy brief demonstrates the importance of legal services for people living with HIV. The policy brief presents the results of a study on the role of legal services in ensuring access to care for people with HIV/AIDS. It concludes that legal services are vital to helping people living with HIV to access care, use entitlement programs, and meet subsistence needs by overcoming immediate barriers to underserved populations, including families, foreign-born persons, and incarcerated persons. Because legal services "are a core component in the network of HIV/AIDS-related services" but such programs have relatively small budgets and few providers, the study makes recommendations for expanding access to and the capacity of HIV-related legal service programs.

The policy brief also contains two additional studies. The first, Use of CARE Act Funds to Purchase Health Insurance for People with HIV/AIDS, was undertaken to educate CARE Act grantees and other providers on the use of Title II funds to purchase health insurance for low-income people living with HIV. It concludes that health insurance continuation is a cost effective method for providing treatment and care, and makes recommendations for assessing the use of Ryan White funds for purchasing health insurance. The final study, Release Planning Needs for Federal Inmates with HIV/AIDS in Community Placement Facilities, assesses policies, procedures, and barriers to care for releasing inmates with HIV/AIDS in community settings. It finds that inmates need more and better quality services to transition into community settings and avoid returning to high risk behavior, but that lack of consistent policies, such as those regarding confidentiality, pose obstacles to corrections and halfway houses providing release planning. The study makes suggestions to overcome these obstacles.

The studies were undertaken to inform future policy directions and suggest potential changes for the reauthorization of the Ryan White CARE Act.