Recorded presentation

Ijeoma Nwachuku, PhD and Earl H. Leonard, MS. Office of AIDS Programs and Policy, Los Angeles County Department of Health Services, 600 South Commonwealth Avenue, Suite 200, Los Angeles, CA 90005, (213) 351-8301, inwachuku@dhs.co.la.ca.us

BACKGROUND: 24,513 HIV-positive and AIDS-diagnosed clients accessed Ryan White Care Act (RWCA)-funded services within Los Angeles County (LAC) in calendar year 2002. METHODS: Funded by HRSA’s Client Demonstration Project, LAC uses the IMACS/Casewatch system to collect RWCA Title I-IV client level data. IMACS/Casewatch is a comprehensive data source which includes client composition, health outcomes, and service utilization. Analysis was completed using data from the IMACS/Casewatch system. CD4 counts, upon entry into medical care services, were analyzed for current clients. Data were compared to assess the existence of racial disparities. RESULTS: Nearly two-thirds (65%, n=15,824) of RWCA-funded clients utilized available medical outpatient services in 2002, consuming a combined total of 240,714 service units. Significant racial disparities were identified. Among the disparities found, clients of color were significantly more likely than White clients to enter medical services with CD4 counts below 200. Differences were significant when comparing Whites with African-Americans (p<.001), Latinos (p<.001), Asian/Pacific Islanders (p<.053), as well as other clients of color (p=.001). Also, when comparing change in CD4 counts between baseline and year-end, African-Americans (p<.001), Latinos (p<.001), Asian/Pacific Islanders (p<.021) and other clients of color (p<.004) were significantly more likely to experience a decrease in CD4 counts than Whites. CONCLUSION: The data suggests that people of color enter into medical care at a much later stage of disease progression than their White counterparts. Data further suggests greater difficulty stabilizing and improving health following medical intervention. Intensive prevention and care strategies directed towards at-risk and HIV-positive people of color are imperative.

Learning Objectives: This presentation is designed to help participants

• Develop the skills necessary to evaluate health outcome data.
• Understand contributing factors to racial disparities in medical care access
• Discuss approaches to care services that are specifically designed to meet the needs of HIV-positive clients of color.

Keywords: Health Care Access, Underserved Populations

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.

Recorded presentation