Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115827

William D. King, MD, JD¹, George Rust, MD, MPH², and Robert Levine, MD². (1) Integrated Substance Abuse Program, University of California at Los Angeles, 11075 santa monica Blvd, los Angeles, CA 90025, (2) Director, National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, 404-756-5740, rlevine@msn.edu

Women, Blacks and Hispanics are more likely to be on Medicaid as compared to men and Whites for HIV clinical services. We analyzed 1998 State Medicaid claims files from five states with mid range HIV prevalence to assess racial and gender disparities in the receipt of highly active antiretroviral therapy (HAART). ICD-9 codes were used to identify persons, ages 13-64 with a diagnosis of HIV/AIDS or a HIV/AIDS defining illness .FDA approval dates and 1998 CDC guidelines identified available antiretrovirals and recommended HAART regimens. Descriptive statistics and multivariate analyses were conducted to determine the impact of age, gender, and race on the receipt of HAART. We identified 7,972/ 1,789,308 persons (0.44%) with a diagnosis of HIV/AIDS. The median age was 39; 56% were female; 53%, Black and 45%, Hispanic (45%). Logistic regression models demonstrated persons younger than 29 (<20 OR 2.99, 20-29 OR 1.64, both p<0.001) or Black (OR 1.26, p <0.001) were less likely to receive HAART. Separate regression models of Black and White recipients conducted because of a significant interaction between race and gender, demonstrated that the age disparity within the White model mirrored the full model; whereas within the Black model, persons from the age of 40-49 were also less likely to receive HAART (p<0.001). Black and White women were less likely to receive HAART (OR1.7, OR 1.9 both p< 0.001). Black or White female HIV positive Medicaid recipients did not have the same rate of HAART receipt despite the elimination of a financial barrier to access.

Learning Objectives:

• Describe Racial and Gender disparities in HIV care among Medicaid recipients;
• Assess the utility of Medicaid Claims Data for analyses;
• Construct cohorts of HIV Positives and Persons with AIDS from Medicaid Claims Data using ICD-9 codes;
• Discuss policy solutions to reduce disparities in HIV care

Keywords: Antiretroviral Combination Therapy, Health Disparities

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.