Health services use by urban women with or at risk for HIV-1 infection: the HIV Epidemiology Research Study (HERS).

摘要: OBJECTIVE To characterize health services use by urban women with or at risk for HIV-1 infection enrolled in a prospective multicenter study. METHODS 1310 16 to 55 years of age who were recruited between April 1993 and January 1995 four centers (Baltimore, Maryland; The Bronx, New York; Detroit, Michigan; Providence, Rhode Island). HIV-1-seropositive without AIDS-defining illness oversampled ratio 2:1 comparison HIV-1-seronegative women. At baseline study visit, the received physical laboratory examinations, including CD4+ counts, interviewed regarding HIV behavior, use, clinical data. RESULTS 863 430 HIV-1-seronegative. Fifty-two percent reported injection drug (IDU) since 1985, 48% acquired through sexual contact. Seventy-seven African American, 23% white, 16% Hispanic. median was 35 years. HIV-seronegative significantly less likely have insurance (19%) than HIV-seropositive (30%; p < .001). Among women, 68% had cell counts <500/microl, 64% asymptomatic. Sixty-four an outpatient hospital visit past 6 months, as 86% (p 0.001). Hospitalization months also higher (22% vs. 12%; Despite heavy services, only 49% <200/microl current antiretroviral therapy, 58% Pneumocystis carinii pneumonia (PCP) prophylaxis. after adjusting count, symptoms, race, site, IDUs regular doctor recent more be hospitalized emergency department (ED) non-IDUs. In multivariate analyses persons, American similar access care therapy PCP prophylaxis did white but previous taking opportunistic (OI) Health HIV-related therapies not differ Hispanic infection. CONCLUSION Although both high levels medical antiretrovirals OI low throughout, used primary receive episodic care. IDU race independently associated decreased services.