Sabrina Matoff, MA, HRSA Office of Women's Health, 5600 Fishers Lane, Room 10C-09, Rockville, MD 20857, 301 443-8664, smatoff@hrsa.gov, Richard Conviser, PhD, Chief, Service Evaluation and Research Branch - HRSA, Office of Science and Epidemiology, HIV/AIDS Bureau, 5600 Fishers Lane, Rm 7C-07, Rockville, MD 20857, and Gregory Fant, PhD, HIV/AIDS Bureau, Office of Science and Epidemiology, Health Resources and Services Administration, Parklawn Bldg., Rm. 7-90, 5600 Fishers Lane, Rockville, MD 20857.

Background

HCSUS and more recent HIV Research Network (HIVRN) studies show continuing disparities in access to HAART by women, African-Americans, and injection drug users, e.g., HIVRN data for 2000 and 2001 show that controlling for disease stage and outpatient utilization, women were 43% less likely than men and injection drug users (IDUs), 69% less likely than non-IDUs to receive HAART.

Ancillary service use may improve access to optimal care. This study examines (1) whether there are demographic disparities in access to ancillary services; and (2) what association ancillary service use has with disparities in use of clinical care services, including HAART.

Methods

The Federally-funded HIVRN is a convenience sample of 18 U.S. clinical care sites serving more than 15,000 people living with HIV/AIDS. In 2003, interviews were conducted with a stratified sample of 950 clients at 15 HIVRN sites; data (available in March 2004) include self-reported case management, mental health service, and substance abuse treatment. Bivariate and multivariate analyses of interview and clinical data will examine associations of demographic variables with ancillary service use, and associations of both with inpatient and outpatient service use and HAART access.

Results

The study will show whether similar disparities in access to clinical services apply to ancillary services, and whether ancillary service use mitigates disparities in clinical care services and HAART receipt.

Conclusions

This study assesses the extent to which persistent disparities in HIV clinical care utilization carry over to and may be further explained by variations in ancillary service use patterns.

Learning Objectives: