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Raffaella E. Espinoza, BA MPH candidate¹, Héléne Carabin, DVM, PhD¹, Marguerite S. Keesee, MA², Tim R. Brittingham, MSW², Kermyt G. Anderson, PhD³, Linda Machado, MD⁴, Nancy K. Sonleitner, PhD², and Morris Foster, PhD³. (1) Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 N.E. 13th St., Oklahoma Ctiy, OK 73190, (405) 271-2229, helene-carabin@ouhsc.edu, (2) Center for Health Ethics, Research and Policy, University of Oklahoma, 3200 Marshall Ave, Norman, OK 73072, (3) Department of Anthropology, University of Oklahoma, 521 Dale Hall Tower, Norman, OK 73019, (4) Infectious Diseases Section (111/c), Oklahoma City VA Medical Center, 921 NE 13th Street, Oklahoma city, OK 73104

Objective: To estimate the proportion of HIV/AIDS patients who were provided two types of standards of care in five demonstration projects located along the U.S. - Mexico border.

Method: The study population consists of 711 predominately Hispanic HIV+ patients receiving HIV/AIDS medical services from one of five Health Resources and Services Administration, Special Projects of National Significance Border Health projects. Most HIV/AIDS treatment guidelines recommend antiretroviral therapy for patients with a CD4+ count <200. Standard of care was defined here as 1) initiating antiretroviral therapy within 2 quarters of a CD4 count <200 and 2) CD4 count and HIV viral load within 8 weeks before or after the first visit. “New” patients were defined as those without prior HIV treatment or medical care and first received care between January 1, 1999 and November 30, 2004. The data were extracted from medical charts following informed consent.

Results: 98.4% of 711 medical charts indicated that the first standard of care was met. Among the 202 medical charts from new patients, 81.1% indicated that the second type of standard of care was met. However, there were large variations between sites regarding the second type of standard of care. The highest proportion of charts indicating substandard care was 23% which was 1.52 (95% CI = 1.02, 2.26) times higher than the site with the lowest proportion.

Conclusion: The standard of care provided to all HIV/AIDS patients is very high. However, the standard of care provided to new HIV patients varies between sites.

Learning Objectives:

• To estimate the proportion of HIV/AIDS patients who were provided two types of standards of care in five demonstration projects located along the U.S. - Mexico border.

Keywords: HRSA, HIV/AIDS

Related Web page: www.ou.edu/border/

Presenting author's disclosure statement:

Not Answered