Assessing Receipt of Medical Care and Disparity Among Persons With HIV/AIDS in San Francisco, 2006-2007
May 11, 2011
In San Francisco, "a high proportion" of people with HIV/AIDS establish "timely and adequate" care after learning of their HIV-positive status, according to the authors of the current study. Even so, the team noted that delayed entry into care for some patients, as well as markers of insufficient care, demonstrate "a need to improve access to and sustainability of HIV-specific medical care."
The researchers used data from HIV/AIDS surveillance case registry to assess the timing of entry into medical care and the level of care received after diagnosis, as well as to identify characteristics associated with delayed and insufficient care among individuals diagnosed with HIV/AIDS in San Francisco between 2006 and 2007.
Laboratory reports of HIV viral load and CD4 tests were used as a marker for receiving medical care. The Kaplan-Meier product limit method was used to estimate the time that elapsed between HIV diagnosis and entry into care. The proportional hazards model was applied to determine independent predictors of delayed entry into care. An average of less than two viral load/CD4 tests per person-year of follow-up was defined as insufficient care. Predictors of insufficient care were assessed using a logistic regression model.
The results indicated that an estimated 85 percent of patients with HIV/AIDS entered care within three months of diagnosis. By 12 months, 95 percent were in care.
Those more likely to delay care were persons born outside the United States and those who were tested at public counseling and testing sites. Of the patients, 19 percent were deemed to have received insufficient care. "Younger persons and those diagnosed at a hospital were more likely to receive insufficient care," the authors found.
03.2011; Vol. 23; No. 3: P. 383-392; Ling C. Hsu, Mi Chen, Jessica Kali, Sharon Pipkin, Susan Scheer, Sandy Schwarcz
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