Caring for People With Human Immunodeficiency Virus Infection

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

Caring for People With Human Immunodeficiency Virus Infection

New England Journal of Medicine (12/24/98) Vol. 339, No. 26, P. 1927
Steinbrook, Robert

In an editorial appearing in the New England Journal of Medicine, Dr. Robert Steinbrook, a deputy editor of the journal, comments on a study by the HIV Cost and Services Utilization Consortium published in the same issue. According to the study--conducted in early 1996--an estimated 292,000 to 372,000 people in the United States receive care for HIV during a six-month period. The study showed that a disproportionate number of people receiving care were male, African-American, poor, unemployed, and lacked private health insurance. Much of the total expenditure by patients went to prescription drugs. The author notes that there are probably more people receiving care today due to outreach programs. He also states that the total expenditure on medication has probably increased since the study period due to combination therapy and new medications. Steinbrook points out that the availability of medications and care differs from state to state depending on AIDS drug assistance programs and other factors, even though the federal government has spent billions of dollars supporting medication programs. He contends that there is no reason why this should be so and recommends that the government--which pays for a large portion of HIV medications--negotiate with pharmaceutical companies to reduce the cost of the drugs and, therefore, increase access. He also suggests that the federal government expand Medicaid to cover asymptomatic HIV-infected individuals with low income.

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