4200.0: Tuesday, November 14, 2000 - 2:30 PM

Abstract #8213

Association between ancillary services and entry, retention, and clinical outcomes for HIV-infected women

M Miller, LPN, MPH1, N Schmidt, MPH2, C Schieffelin, MPH3, N Fuchs, MPH3, K Kirkhart, PhD3, B Brown, PhD3, and P Kissinger, PhD2. (1) Epidemiology, Tulane University Graduate School, 1430 Tulane Avenue, SL-18, New Orleans, LA 70112, 504-988-6842, manyadm@mailhost.tcs.tulane.edu, (2) Epidemiology, Tulane University, c/o Patricia Kissinger PhD 136 South Roman Street, New Orleans, LA 70112, (3) FACES, Children's Hospital, New Orleans, 200 Henry Clay Avenue, New Orleans, LA 70118

Objectives: The purpose of this study was to evaluate the association between ancillary services and HIV-related clinical and behavioral outcomes. Methods: Data were obtained from databases systematically maintained by the Family Advocacy, Care and Education Services (FACES) Program and the HIV Outpatient Program (HOP), in New Orleans. HIV-infected women receiving primary care at HOP and FACES ancillary services between 1/1/97 and 12/31/98 were eligible. Data were analyzed using generalized estimating equations (GEE) with STATA software. Results: The majority of eligible women were African-American (86.7%), infected heterosexually (78.8%), and had absolute CD4 counts greater than 200 (58.6%). After adjusting for confounders, receiving more than four total contacts or services per month was significantly associated with being prescribed a protease inhibitor (OR 1.82, 95% CI 1.25-2.66); improved adherence (OR 2.13, 95% CI 1.39-3.33); improved retention (OR 2.77, 95% CI 1.84-4.19); one or more hospitalizations per month (OR 2.48, 95% CI 1.44-4.26); and enrolling on a research protocol (OR 9.70, 95% CI 3.58-26.32). Receiving more than one transportation service per month was significantly associated with improved adherence (OR 2.70, 95% CI 1.56-4.76); improved retention (OR 3.07, 95% CI 1.79-5.24); one or more emergency room visits per month (OR 3.66, 95% CI 1.75-7.62); and one or more hospitalizations per month (OR 2.72, 95% CI 1.52-4.86). Receiving more than one contact with case managers per month was associated with improved retention (OR 2.63, 95% CI 1.60-4.32). Conclusion: Receipt of ancillary services is associated with improvements in multiple outcomes for high risk, HIV-infected women.

Learning Objectives:

    1. To describe the population of high-risk HIV-infected women receiving ancillary social services
    2. To articulate the association between ancillary social services and entry and retention in primary care
    3. To articulate the association between ancillary social services and clinical and behavioral outcomes for HIV-infected women
    4. To demonstrate comprehension of methodological issues in studying the association between ancillary services and primary care

    • Keywords: Women and HIV/AIDS, Social Services

    Presenting author's disclosure statement:
    Organization/institution whose products or services will be discussed: None
    I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

    The 128th Annual Meeting of APHA