Response to Symptoms Among a U.S. National Probability Sample of Adults Infected with Human Immunodeficiency Virus

Published in: Medical Care Research and Review, v. 59, no. 1, Mar. 2002, p. 36-58

Posted on RAND.org on December 31, 2001

by Amy Kilbourne, Ronald Andersen, Steven M. Asch, Terry T Nakazono, Stephen Crystal, Michael Stein, Allen Gifford, Eric G Bing, Samuel A. Bozzette, Martin F. Shapiro, William Cunningham

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Previous studies concerning disparities in Human Immunodeficiency Virus (HIV) services use among vulnerable groups did not control for specific clinical need for care such as symptom events. Using the Andersen Behavioral Model of Health Services Use, the authors determined whether minorities, women, and the less educated (vulnerable groups) were less likely to receive care for HIV symptoms. Persons enrolled in the HIV Cost and Services Utilization Study were asked whether they received care for their most bothersome symptom. Surprisingly, minorities and women were no more likely to go without care than other groups. Those with Medicaid, Medicare, private health maintenance organization (HMO) insurance, or no insurance were less likely to receive care for symptoms than those with private-non-HMO insurance. Vulnerable groups were no less likely to use services for HIV-related symptoms when need for care was considered. However, disparities may exist for symptom-specific care among HIV infected persons covered by public or HMO insurance.

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