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National News

Federal Program Patients Mostly Minorities With Barriers to Care

September 16, 2002

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

As officials of the Health Resources and Services Administration convened the recent 2002 Ryan White Comprehensive AIDS Resources Emergency conference, they noted the release of several new reports. As an agency of the Department of Health and Human Services, HRSA administers CARE Act programs, which received $1.91 billion in 2002. Released at the conference was HRSA's annual report -- The AIDS Epidemic and the Ryan White Comprehensive AIDS Resources Emergency Act -- Progress Report, 2002.

Four other studies released by HRSA, conducted mainly by the University of California, San Francisco, will be published in Public Health Reports. They identified the following barriers to HIV health care access:

  • Restrictive eligibility criteria for public insurance

  • Income and benefits limits in state programs

  • Lack of information


  • Distrust of government

  • HIV-related stigma

In 2000, CARE programs funded more than 4 million patient visits in its two largest programs: Title I grants to metropolitan areas and Title II grants to states and territories. In 2000, 69 percent of all CARE Act clients were minorities, up from 66 percent in 1997. The four other studies available from HHS are:

  • "Responding to Racial and Ethnic Disparities in Use of HIV Drugs: Analysis of State Policies." UCSF researchers used state claims data to assess trends by race/ethnicity in Medicaid and CARE Act's AIDS Drug Assistance Programs in Calif., N.Y., Fla. and Texas. They found in most cases, the reduction of death rates among African-Americans and Latinos between 1996 and 1998 was not as dramatic as the drop in death rates among non-Latino Whites in New York, Florida and Texas. They cited policy barriers related to immigration status and residency and limits on Medicaid eligibility for disability, as well as state-imposed income and benefit limits as major barriers to care.

  • "Access to and Use of HIV Antiretroviral Therapy: Variation by Race/Ethnicity in Two Public Insurance Programs in the US." Researchers from the NY AIDS Institute examined reimbursement claims and AIDS surveillance data in N.Y., Calif., Fla. and Texas. to determine access to and use of HAART. The researchers concluded that African-Americans were more likely to access HIV drugs through Medicaid, than ADAP since Medicaid participation is limited to those with poverty level incomes. African-Americans also seek care later than sooner due to requirements for disability status.

  • "Differences by Race and/or Ethnicity on Use of Antiretrovirals and Prophylaxis for Opportunistic Infection: A Review of the Literature," by UCSF researchers, assessed published articles that analyzed race/ethnicity as a predictor of antiretroviral or HIV-related medication use. They found evidence of pervasive racial disparities in antiretroviral use.

  • "The HIV Care Continuum in Publicly Funded Clinics" by UCSF researchers assessed data from HIV specialty clinics serving minorities in N.Y., Calif., Texas and Fla. They found that patients who tested relatively late, after infection at all sites, treatment did not take priority over basic family needs among those living in poverty. It also found that comprehensive support services were critical in order to treat the poor. For more information about the conference or the reports, call HHS at 301-443-3376.

Back to other CDC news for September 16, 2002

Previous Updates

Adapted from:
AIDS Policy & Law

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
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