Background: Comorbidity rates and service needs are high among people living with
HIV/AIDS (PLWHA). The effects of service utilization and unmet service needs on antiretroviral
therapy (ART) adherence are not well understood. The purpose of this study was to investigate associations
among PLWHA’s service utilization, unmet service needs, and ART adherence.
Methods: PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment
project in 2016. Participants completed a self-administered questionnaire on paper or online.
The independent variables were service utilization and unmet service needs. The outcome variable
was ART adherence. Multivariable logistic regression analyses were conducted to examine associations
between the amount of utilized services and unmet service needs with ART adherence.
Results: Only 12 (7.5%) participants reported they received all the needed services. The ART nonadherence
group showed significantly higher unmet medical service needs compared to the ART
adherence group (p=0.007). Unmet medical service needs (Adjusted Odds Ratio (AOR) 0.69, CI
0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were negatively associated
with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support
services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART
Conclusion: The results of this study indicate that health promotion programming should focus not
only on introducing new services at the community level, but also work to optimize the availability
and awareness of current services. Furthermore, health promotion programs should focus on filling
service coverage gaps and improving the facilitation of services.