Disparities in Access to Acupuncture Care for HIV/AIDS: Even when care is free, women experience decreased access

Background: Acupuncture treatment has been provided by the AIDS Care Project since 1989. Following loss of federal funding in 2005, hundreds of patients lost access to care. Although local funding sources made it possible to continue providing treatment at a vastly reduced capacity, the purpose of this evaluation was to determine if continued access to care was associated with gender or other sociodemographic factors. Methods: A review of medical records and treatment utilization was undertaken to assess baseline characteristics of individuals with HIV/AIDS who used acupuncture. Records of all patients receiving care between 2000 and 2007 were identified and abstracted to determine age, gender, ethnicity, HIV-status, distance from residence to clinic, history of alcohol and substance use, and mental health status. Results: Our search identified records of 1017 individual patients receiving acupuncture care during the relevant time period. All patients receiving care were living at or below the federal poverty level. Approximately 25% were female; 24% were African-American; 23% were Hispanic/Latino; 53% were white; 25% had an AIDS diagnosis and 75% had been diagnosed HIV-positive; 20% reported current alcohol or drug use. Unadjusted bivariate associations showed that two groups were less likely to have access to acupuncture following budget cuts: women (p=0.0259) and patients reporting current alcohol use at intake (p=0.0011). Results of logistic regressions indicated that female gender was associated with borderline significance (p=0.0884). Conclusions: Disparities in access to care, even when care is offered at no cost to patients, can occur when federal support is withdrawn. Efforts to safeguard women's well-being need to be maintained and intensified.