Racial differences in diagnosis among HIV/AIDS female veterans receiving care in Veterans Affairs facilities

Objectives: Women receiving HIV care in Veterans Affairs facilities represent a very small percentage compared to male veterans but they constitute an important group for following up HIV care. We examined racial differences in four major diagnoses (AIDS defining illness, mental disorders, respiratory conditions, and digestive conditions) and facility visits made for HIV services received by women registered in the Immunology Case Registry. Methods: Cross-sectional analysis of service use data for 313 (73%) black and 118 (27%) white women who used services in 2003 was conducted. Chi-square and t-tests were used to assess differences in major diagnoses reported in HIV/AIDS patients and corresponding number of visits for HIV care. Results: Of the 431 women with HIV, 60 (14%) were diagnosed with AIDS but there were no racial differences in AIDS diagnosis. Patients had a mean age of 44.4 years while the mean age at AIDS diagnosis was 39.4 years. Majority of women presented AIDS defining illness (53%) and mental disorders (28%) among the four groups of diagnoses. Consistent with current practices in HIV care, most of the facility visits (98%) were made for outpatient services, with nearly half for mental disorders. While there were no differences in the number of inpatient visits, chi-square analyses showed black patients comprised more than 65% of the outpatient visits in all four diagnosis groups (÷2 = 11.04, p<0.05). Conclusions: Although practices have changed to help ease the burden of HIV/AIDS among racial groups, black women with HIV/AIDS are more likely to have mental disorders.