Access to Medical Care and Health-Related Quality of Life for Low-Income Persons with Symptomatic Human Immunodeficiency Virus

The authors conducted a cross-sectional study among 205 low- income HIV-infected symptomatic persons in order to assess the association between accessibility of medical care and HRQOL for persons with HIV disease. Access problems were widespread: 55 percent of the patients traveled longer than 30 minutes to their usual source of care, 49 percent had problems meeting the costs of their care, and 48 percent had problems with clinic hours. Uninsured patients reported worse access (especially in the cost of care) than those with Medicaid or VA insurance. Adjusted HRQOL scores were far lower than those of subjects in a large, national AIDS clinical trial. Worse perceived access was significantly associated with poorer HRQOL for 8 of the 11 HRQOL subscales, even after controlling for relevant variables. If confirmed in a longitudinal study, these will represent important findings relative to access and HRQOL in patients with HIV infection.