Who obtained treatments and who have unmet needs: An analysis of 2013 Illinois HIV Surveillance Data

Background: There are currently over 36,000 people living with HIV in Illinois, and more than half of them have progressed to AIDS. The purpose of this research is to quantify and characterize this unmet treatment need population and characterize who among these populations are willing to get treatments and healthcare in 2013 in Illinois.

Method: Patients who were diagnosed before 2013 but did not receive any form of HIV medical care throughout the year, including viral load testing, CD4 count, and antiretroviral therapy, were identified and analyzed using combined data from Enhanced HIV/AIDS Reporting System (eHARS), AIDS Drug Assistance Program (ADAP), and Illinois Medicaid.

Results: On average, 40% of people living with HIV/AIDS (PLWH/A) in Illinois had unmet medical care need in 2013. People living with HIV but not AIDS (PLWH) were more likely to have unmet need, compared to people living with AIDS (PLWA). When characterized by exposure, close to 50% of PLWH/A who were Injection Drug Users (IDU) had unmet need, higher than other risk categories, which is statistically significance (P<0.001).

Conclusions: This study quantitatively shows that there is a gap between HIV patient treatment needs and medical care in practice. Given the success of antiretroviral therapy and the availability of various drug assistance programs, it surprised that so many patients did not initiate or continue with care. The high level of unmet need in the IDU (Injection Drug User) category indicates that mental and behavioral factors play a critical role in timely care and treatment adherence.