Comparative analysis of healthcare utilization among the non-HIV infected children of HIV/AIDS positive and HIV/AIDS negative parent(s)

Objective: Longer life expectancy coupled with decreased risk of vertical HIV transmission has catalyzed the current surge in children living with HIV infected parent. The study aims to compare healthcare utilization among HIV-negative children staying with HIV/AIDS positive parent to utilization among HIV-negative children of HIV/AIDS negative parent.

Method: This is a retrospective follow-up study of non-HIV-infected children of HIV/AIDS positive parent(s) (ICD-9-CM codes 042, 043, V08) using MEPS (2001-2005) database. The healthcare utilization of this population was compared to randomly selected group of children with non-HIV/AIDS infected parents such that a 1:10 ratio was maintained between the two groups. Multiple survey-regression models of total healthcare expenditure, prescription drug expenditure, number of ER visits, office-based physician and hospitalization visits were estimated.

Results: 98 (497,237 weighed) non HIV-infected children were identified dwelling with their HIV-infected parent(s). The 10% sample of children of non-HIV-infected parent was 980 (7,167,866 weighed). After adjusting for age, gender, race, ethnicity, poverty level & insurance status, differences in the total healthcare expenditure or healthcare utilization between the two groups were statically insignificant. However prescription drug expenditures were significantly different. Child of HIV-parent was found to spend $306.41 (p value = 0.0424) more than the child of Non HIV-parent.

Conclusion: High medication use was seen among HIV-negative children staying with HIV-infected parent(s) in comparison to the children of non-HIV infected parents. Compromised health status of these children or defensive parenting could be the possible explanations. Further investigation is required to understand the underlying reasons for this surplus utilization.