4270.1: Tuesday, October 23, 2001 - Board 2

Abstract #29503

Characteristics of HIV-positive and HIV-negative patients undergoing treatment for tuberculosis in Harlem, NY

Yael Hirsch-Moverman, MS1, Paul Colson, PhD1, Gloria Thomas, MSW2, Frantz Medard, MD3, and Wafaa El-Sadr, MD, MPH, MPA1. (1) Charles P. Felton Nat. TB Ctr., Harlem Hospital Center, 2238 Fifth Ave., New York, NY 10037, (212) 939-8240, yh154@columbia.edu, (2) Div. of Infectious Diseases, Harlem Hospital Center, 506 Lenox Ave., rm 3101A, New York, NY 10037, (3) Charles P. Felton National Tuberculosis Center, Harlem Hospital Center/ Columbia University College of Physicians and Surgeons, 506 Lenox Avenue, New York, NY 10037

Background: Co-infection with HIV is a major issue in the management of TB disease. However, the characteristics and needs of HIV+ patients have not been well defined in contrast to HIV- patients undergoing TB treatment.

Methods: We assessed patients' demographic, substance use, and TB/ HIV knowledge & attitudes in a study of adherence to TB treatment in Harlem.

Results: Of 127 patients with HIV status known at baseline, 94% were African-American or Latino, mean age 42, 64% male, and 37% HIV+. 8.5% of HIV+ married vs. 18.8% of HIV- (p=0.132), 54.3% of HIV+ completed high school vs. 52.6% of HIV- (p=1.000), 2.1% of HIV+ employed vs. 20.0% of HIV- (p=0.005), and 8.5% of HIV+ foreign-born vs. 41.3% of HIV- (p<0.001). Homelessness was 61.7% in HIV+ vs. 37.5% in HIV- (p=0.010). 51.1% of HIV+ reported drug use and 34.0% participated in drug program vs. 26.3% and 6.3% of HIV- (p=0.007, p<0.001). TB knowledge score, out of 24 points, was 16.0 for HIV+ vs. 14.9 for HIV- (p=0.079). HIV knowledge score, out of 12 points, was 9.0 for HIV+ vs. 8.0 for HIV- (p=0.002).

Conclusions: The HIV- patients are more likely to be employed and foreign-born. HIV+ patients have many barriers to completion of therapy: they are more likely to have history of homelessness, and report current drug use. However, their knowledge level of TB and HIV is slightly better than HIV- patients. Programs to promote completion of TB treatment for these two populations must assess patients' needs and develop appropriate interventions.

Learning Objectives: To investigate differences between HIV-positive and HIV-negative TB patients, and discuss implications for program design.

Keywords: Barriers to Care, TB

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 129th Annual Meeting of APHA