The Social Network of Medical Case Managers, Housing Providers, and Health Department Staff in the Ryan White HIV/AIDS Program: A Midwest Case Study

Abstract

Background: Broad networks of providers in the Ryan White system are essential to end the HIV epidemic. Yet, there is little evidence that has assessed social networks of providers within HIV care networks. The purpose of this study is to provide a cross-sectional analysis of the role medical case managers (MCM), housing providers (HP), and health department staff (HDS), play in a Ryan White-funded area.

Methods: All MCMs, HPs, and HDS (N = 57) in a Midwest Transitional Grant Area were invited to participate in a social network survey. Social network composition scores, exponential random graph modeling and ANOVA tests were conducted using SPSS and R Studio.

Results: Communication in this network was significantly more likely between SW of the same provider type (e.g. MCMs communicating with other MCMs, β = .87, p<.001). HDS reported larger overall social networks (F(2,54) = 4.59, p = <.01), larger networks with other provider types (F(2,54) = 9.23, p<.001), and higher quality of relationships with other provider types (F(2,54) = 3.90, p<.05) than MCM or HP. HDS were more likely to communicate across the system than MCMs or HPs (β = .75, p<.001).

Discussion: HDS play an important role in communicating across provider types in care delivery for HIV. Our results indicate that health departments represent essential agencies for broad dissemination of resources and knowledge, and may bridge communication barriers for coordination of housing support and HIV care delivery.