 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Kelly Gebo, MD, MPH, Department of Medicine, Johns Hopkins University, Room 442, 1830 E. Monument St., Baltimore, MD 21287, 410-502-2325, kgebo@jhmi.edu, Haya R. Rubin, MD, PhD, Quality of Care Research/Department of Medicine, Johns Hopkins University, Room 8015, 1830 E. Monument St., Baltimore, MD 21287, and for the HIV Research Network, Department of Medicine, Johns Hopkins Univeristy, Room 442, 1830 E. Monument St., Baltimore, MD 21287.
Background: National data from the mid-1990s suggest racial and gender disparities in opportunistic illness prophylaxis (OIPx) and antiretroviral (ART) use. We compared OIPx and ART use by sex, race/ethnicity, and HIV risk factor in CY 2000.
Methods: We assessed 11,563 patients from seven sites in the HIV Research Network. Indications for PCP prophylaxis (PCPPx) and ART were any CD4 <200 cells/mm3 and CD4<50 for MAC prophylaxis (MACPx). We examined all drugs approved for PCPPx, MACPx, and ART and determined demographic differences using multivariate logistic regression.
Results: Among eligible patients, 87% received PCPPx, 79% received MACPx and 89% received ART. Adjusting for care site, men (Odds Ratio OR 1.45; 95%CI [1.29, 1.62]), blacks (1.24, [1.13, 1.38]), IDUs (OR 1.14, [1.01, 1.28]), heterosexual risk (OR 1.12 [1.01, 1.24]) and >39years (OR 1.28 [1.17, 1.39]) were more likely to receive PCPPx. Blacks (OR 1.41 [1.27, 1.58]), men (OR 1.39 [1.27, 1.58]), heterosexual risk (OR 1.13, [1.01, 1.27]) and <39years (OR 1.12 [1.02, 1.23]) were more likely to receive MACPx. Men (OR 1.36 [1.20, 1.54] and >39years (OR 1.39 [1.24, 1.57]) were more likely to receive ART. IDU’s (OR 0.75 [0.65, 0.86] and blacks (OR 0.70 [0.61, 0.80] were less likely to receive ART.
Conclusions: OIPx remains an important mechanism to prevent morbidity and mortality. ART and OIPx is relatively high, but gender, racial/ethnic and HIV risk group differences still exist that may reflect barriers in the delivery of quality care.
Learning Objectives:
Keywords: HIV/AIDS, Access to Care
Presenting author's disclosure statement:
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.