The 130th Annual Meeting of APHA

Abstract #45940

Elizabeth McSpiritt, MD, MPH¹, Ayse Akincigil, MA², William E. Cunningham, MD, MPH³, Ronald M. Andersen, PhD⁴, Martin F. Shapiro, MD PhD³, and Stephen Crystal, PhD⁵. (1) Inst. for Health, Health Care Policy, and Aging Research, Division on Aging/AIDS Research Group, Rutgers University, 30 College Avenue, New Brunswick, NJ 08901, (2) Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, 30 College Avenue, New Brunswick, NJ 08901, 732-932-8111, emcspiri@rci.rutgers.edu, (3) Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Center for Health Sciences, 10833 Le Conte Avenue, Los Angeles, CA 90095, (4) Department of Health Services, UCLA, 10833 Le Conte Avenue, Room 31-254A CHS, Los Angeles, CA 90024-1006, (5) Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Avenue, New Brunswick, NJ 08901

Objectives: To provide a nationally representative profile of the socioeconomic, clinical, drug abuse, caregiving attributes and health care utilization characteristics of women, and to contrast race and exposure categories. Design: Utilized the HIV Costs and Service Utilization Study (HCSUS), with three waves of interviews between 1996-1998. Main Outcome Variables: Healthcare utilization, including exposure to and consistent use of HAART, outpatient and mental health visits and antidepressant use. Analyses: Comparisons of men and women, with a comparison of women based on race and exposure (heterosexual v. IDU) and of parallel groups of men to differentiate the source of variance in health care access. Results: While women were found to be poorer, younger, less educated and to have greater caregiver responsibilities, they were more likely to make outpatient and mental health visits and to use antidepressants, while no differences were found in HAART use. Black women, as well as Black men, were less likely to use HAART than white women or men, respectively. Bivariate analysis revealed increased utilization by IDU women, including greater use of HAART, outpatient and mental health services and antidepressant use, but these were attenuated in regression analysis. Parallel analysis of men revealed similar results. Conclusions: Although women with HIV were found to be less socioeconomically advantaged, healthcare access examined remained at similar, if not higher, levels. While minority women had lower levels of healthcare utilization, this was mirrored in their male counterparts, indicating that access issues seen in minority women may lie in racial, rather than gender-based, differences.

Learning Objectives:

At the end of the session, participants will be able to
• profile the socioeconomic, clinical, drug abuse, caregiving attributes and health care utilization characteristics of women with HIV
• Compare and contrast groups of women in terms of race/ethnicity and routes of exposure
• Describe the impact of gender, race and exposure on 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.