AEGiS-11IAC: Outpatients care of HIV-infected destitute population: a historical prospective study in Paris, France.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Outpatients care of HIV-infected destitute population: a historical prospective study in Paris, France.

Int Conf AIDS 1996 Jul 7-12; 11:19 (abstract no. We.B.173)
Chauvin P, Mortier E, Carrat F, Imbert JC, Valleron AJ, Lebas J; INSERM, Paris, France. Fax: 33-1-44 73 84 62. E-mail: chauvin@b3e.jussieu.fr.

OBJECTIVES: In France, the entire population theoretically benefits from health coverage, but in fact a fraction of the population does not have access to it. In 1992, for the first time in Paris, a medico-social consultation for destitute patients was incorporated into the outpatients clinic of a University hospital. Our objectives were to describe the social characteristics of the attending destitute population, to compare their clinical characteristics with those of the non-destitute, and to evaluate the efficiency of this consultation.

METHODS: We performed a historical prospective study wherein a cohort of 115 HIV-infected destitute patients, having no health coverage at their first consultation, was compared with a cohort of 183 HIV-infected non-destitute patients, both started since 1992.

RESULTS: 95% of the destitute patients had no stable employment, 32% had no source of income, 75% had no permanent residence and 27% were IV drug abusers. 59% were foreigners, most of whom had legal residence papers and had been in France for more than 3 years. Tuberculosis-free survival was three times shorter in the destitute group than in the control group (RH = 3.2, IC 95% = [1.1 - 9.4]). Medical compliance, access to anti-retroviral treatment and hospitalisation were identical in both groups. No difference was observed in terms of occurrence of a new AIDS-related disease during follow-up when full blown AIDS before entry, CD4 count at entry and transmission group were taken into account in multivariate analysis.

CONCLUSION: From the moment that destitute patients attend such a medico-social facility, their access to care is as good as, if not better, that of non-destitute patients. The development of outpatients medico-social facilities for destitute patients living with HIV must be a public health priority.

Keywords: AEGIS, Prospective Studies, Ambulatory Care, Paris, France, Acquired Immunodeficiency Syndrome, Tuberculosis, CD4 Lymphocyte Count, HIV Infections, Ambulatory Care Facilities, Population, Income, Public Health, Human, ICA11

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