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Racial/ethnic disparities in service utilization among people living with HIV/AIDS in Los Angeles county

Denise F. Johnson, MPH, PsyD, Amy R. Wohl, PhD, Anthony C. Ewell, BA, and Alexander S. Carruth. HIV Epidemiology Program, Los Angeles County Department of Health Services, 600 S. Commonwealth Ave, Suite 1920, Los Angeles, CA 90005, 213-351-8545, denjohnson@ladhs.org

Background: African Americans and Latinos with HIV/AIDS suffer higher morbidity and mortality rates than HIV-infected whites. Previous analyses have suggested that disparities in access to health care and utilization of essential services are related to poorer health outcomes among people of color.

Methods: We compared need and utilization of services by race/ethnicity among HIV-infected people who were interviewed from 2000 to 2004 for the Supplement of HIV/AIDS Surveillance (SHAS) Project, a population-based study in Los Angeles County. Participants reported which services they needed in the past 12 months and whether they were able to access those services. We performed bivariate analyses and logistic regression to examine associations between race/ethnicity, need, and service utilization.

Results: People of color (African Americans and Latinos, n=614) were significantly more likely than whites (n=194) to report needing transportation services (41% vs. 24%), social services, including insurance assistance (38% vs. 29%), assistance in finding shelter (24% vs. 13%), and information on HIV risk reduction (22% vs. 11%). Controlling for income, we found racial/ethnic disparities in service utilization among participants in need. Whites were more likely than non-whites to have accessed assistance finding meals (p-value < .01), social services (p-value = .02), and mental health services (p-value = .04). Among people of color, not knowing “where to go or who to call” was the main reason mental health, social services, and food assistance were not accessed (50%, 36%, and 27%, respectively). In addition, 25% reported not utilizing social services they needed because they weren't eligible or were denied service, and 23% reported not receiving meal assistance because they did not complete the application process.

Conclusion: These findings reveal disparities and barriers to utilization of needed services. Further research is warranted to identify underlying factors that influence access to services and to assure equitable dissemination of information regarding services available to people living with HIV/AIDS.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Keywords: HIV/AIDS, Access and Services

Presenting author's disclosure statement:

Any relevant financial relationships? No

Ethics, Human Rights and the HIV/AIDS Crisis in the African American Population

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA