Delivering HIV Services to Vulnerable Populations: A Review of CARE Act-Funded Research

• Published in: Public health reports (1974) 2002-03, Vol.117 (2), p.99-113
• Main Authors: Martha M. Mc Kinney, Marconi, Katherine M.
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - economics; Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - therapy; AIDS; Antiretroviral Therapy, Highly Active - economics; Antiretroviral Therapy, Highly Active - utilization; Antiretrovirals; Biological and medical sciences; Care and treatment; Comprehensive Health Care - economics; Comprehensive Health Care - standards; Epidemiology; Evaluation Studies as Topic; Federal legislation; Government grants; Health insurance; Health policy; Health Services Accessibility - economics; Health Services Accessibility - standards; Highly active antiretroviral therapy; HIV; HIV Infections - economics; HIV Infections - epidemiology; HIV Infections - therapy; HIV positive persons; Humans; Inequality; Medicaid; Medical Assistance - legislation & jurisprudence; Medical sciences; Medically Underserved Area; Men; Outcome Assessment (Health Care); Patient care; Poverty; Practice; Prevention and actions; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Specific populations (family, woman, child, elderly...); United States; United States - epidemiology; Vulnerable Populations
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1016/S0033-3549(04)50116-4

This article summarizes key findings from evaluation and research studies that have received financial support from the HIV/AIDS Bureau of the Health Resources and Services Administration or from Ryan White Comprehensive AIDS Resources Emergency (CARE) Act grantees. These studies suggest that the CARE Act has improved but not equalized service accessibility, quality, and outcomes for different populations living with HIV disease. Evaluations of access to highly active antiretroviral therapy (HAART) found that uninsured patients, women, people of color, and injection drug users waited much longer than others to receive the new therapies. These disparities were not uniform across study sites, suggesting that clinic characteristics and geographic location have a major influence on prescribing patterns. Once patients gained access to HAART, health insurance status made little difference in clinical outcomes.