The 130th Annual Meeting of APHA

Abstract #41635

Danielle Greene, MPH, Mari P. Millery, PhD, Emily A. Nishi, MPA, Alicia Peters, BA, Nancy L VanDevanter, DrPH, and the Co-Investigators of the Northern Manhattan Women and Children HIV Project. Center for Applied Public Health, Mailman School of Public Health, Columbia University, 722 W. 168th St, New York, NY 10032, 212-305-0409, dg134@columbia.edu

The HIV/AIDS epidemic continues to be a dynamic one. Medical and technological advances including the advent of AZT to reduce perinatal transmission, protease inhibitors to control disease progression, and establishment of comprehensive systems of care to provide both medical and social services have dramatically changed the service needs of people living with HIV/AIDS. This abstract examines how this has affected service utilization by reviewing service utilization data for HIV-positive women and children receiving comprehensive care from a 5 member consortium of hospitals and a university serving 1600 women, children, youth and families per year in New York City for the period of 1996-2001. Findings: An 80% reduction in the number of clients hospitalized and the total number of hospital admissions was seen between 1996 and 2000 Participation in clinical trials and other research protocols dropped approximately 30%, and the rate of new enrollments into research decreased substantially. Many new types of supportive services were added to the model of comprehensive care over time particularly as our pediatric clients age into adolescence. Our findings indicate to us that an effective model of comprehensive care needs to be able to evolve over time. Improved medical treatments and increased access to these treatments have reduced the need for inpatient care. Clients' interest in participating in research seems to have decreased as experimental treatments became the standard of care and innovative treatments were not on the horizon. The need for outpatient care and a wide range of supportive services remains high.

Learning Objectives: At the end of the session, the learner will be able to

• List the services women and children with HIV currently utilize,
• articulate how these service needs have changed as the epidemic changed,
• recognize that a strong need for services remains among HIV-infected women and children.

Keywords: HIV/AIDS, Health Care Utilization

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.