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APHA Scientific Session and Event Listing

Recorded presentation

Anthony A. Lew, MPH¹, Yunyin W. Hu, MPH², and Douglas Frye, MD, MPH². (1) University of California, Hastings College of the Law, 198 McAllister Street, San Francisco, CA 94102, 310-415-8225, lewa@uchastings.edu, (2) HIV Epidemiology Program, Los Angeles County Department of Health Services, 600 S. Commonwealth Ave. Suite 1920, Los Angeles, CA 90005

Background: For many persons diagnosed with AIDS, greater geographic distance between the doctor's office and one's residence may reduce optimal access to health care. The objective of this population-based study is to estimate the variation of this average distance for white, black, and Hispanic persons reported with AIDS in Los Angeles County (LAC).

Methods: The analysis was performed on 6,159 persons who were reported with AIDS in LAC from 2000-2004. Using MapInfo GIS software, the number of miles between a person's residence at time of diagnosis and the health facility where they were diagnosed was precisely calculated. Multivariable linear regression models were fit separately for men and women to estimate the racial/ethnic differences in distance to care while controlling for age, mode of HIV transmission, presence of opportunistic infections (OI), and public/private facility.

Results: Black persons had the greatest mean distance to care (6.42 miles), followed by Hispanics (6.37 miles) and whites (5.40 miles). Black (1.23 miles, p=0.014) and Hispanic men (1.20 miles, p=0.012) had significantly greater distance to care than their white counterparts when controlling for other variables. However, no racial/ethnic differences were observed among women. Having sex with men (p=0.009), injection drug use (p=0.001), and having OI (p=0.004) were associated with distance to care among men, but not women. Receiving care from a public facility (p<0.001) was strongly associated in both models.

Conclusions: Our regression analyses provide evidence of significant, quantifiable differences in distance to care between different demographic groups of AIDS patients in Los Angeles County.

Learning Objectives:

• Describe the racial/ethnic differences and other factors associated with distance to care among AIDS patients in a multiethnic population.
• Develop methods to measure distance to care that are appropriate for local communities.
• Describe ways in which service providers can utilize distance to care information in their programmatic planning.

Keywords: HIV/AIDS, Geographic Information Systems

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation