Association of Race, Substance Abuse, and Health Insurance Coverage With Use of Highly Active Antiretroviral Therapy Among HIV-Infected Women, 2005

• Published in: American journal of public health (1971) 2010-08, Vol.100 (8), p.1493-1499
• Main Authors: LILLIE-BLANTON, Marsha, STONE, Valerie E, SNOW JONES, Alison, LEVI, Jeffrey, GOLUB, Elizabeth T, COHEN, Mardge H, HESSOL, Nancy A, WILSON, Tracey E
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Addictive behaviors; Adult; Adult and adolescent clinical studies; African Americans; African Americans - ethnology; AIDS; Antiretroviral drugs; Antiretroviral Therapy, Highly Active - economics; Antiretroviral Therapy, Highly Active - utilization; Biological and medical sciences; Cross-Sectional Studies; Drug addiction; Drug addictions; European Continental Ancestry Group - ethnology; Female; Follow-Up Studies; General aspects; Health Care Surveys; Health insurance; Health Services Accessibility; Healthcare Disparities; Hispanic Americans - ethnology; Hispanic people; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - ethnology; Human immunodeficiency virus; Humans; Insurance coverage; Insurance Coverage - economics; Insurance, Health - economics; Logistic Models; Medicaid - statistics & numerical data; Medical sciences; Medically Uninsured - statistics & numerical data; Medication Adherence - ethnology; Medication Adherence - statistics & numerical data; Middle Aged; Miscellaneous; Multivariate Analysis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Research and Practice; Socioeconomic Factors; Studies; Substance-Related Disorders - complications; Substance-Related Disorders - ethnology; Toxicology; United States - epidemiology; White people
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2008.158949

We examined racial/ethnic disparities in highly active antiretroviral therapy (HAART) use and whether differences are moderated by substance use or insurance status, using data from the Women's Interagency HIV Study (WIHS). Logistic regression examined HAART use in a longitudinal cohort of women for whom HAART was clinically indicated in 2005 (N = 1354). Approximately 3 of every 10 eligible women reported not taking HAART. African American and Hispanic women were less likely than were White women to use HAART. After we adjusted for potential confounders, the higher likelihood of not using HAART persisted for African American but not for Hispanic women. Uninsured and privately insured women, regardless of race/ethnicity, were less likely than were Medicaid enrollees to use HAART. Although alcohol use was related to HAART nonuse, illicit drug use was not. These findings suggest that expanding and improving insurance coverage should increase access to antiretroviral therapy across racial/ethnic groups, but it is not likely to eliminate the disparity in use of HAART between African American and White women with HIV/AIDS.