AIDSWEEKLY Plus; Monday, May 22, 2000
Prepared by AIDS Weekly editors from staff and other reports

The study results suggest the need to improve access by the most vulnerable groups to potentially beneficial HIV therapies.

"Access to certain anti-HIV pharmaceutical regimens may be especially, and increasingly, beneficial as new agents and combinations of agents become available," said lead author Ronald Andersen, PhD, of the University of California at Los Angeles. "However, traditionally vulnerable groups are less likely to receive appropriate HIV treatment and more likely to experience delays in receiving that treatment."

The study examined 2,776 HIV infected adults' access to highly active antiretroviral therapy (HAART), which the researchers defined as certain combinations of antiretroviral drugs that are particularly beneficial in HIV care. The research looked at factors associated with early HAART access, including predisposing and enabling factors and need.

Traditionally vulnerable groups were less likely to have early access to HAART than were more traditionally advantaged groups, with the most advantaged group being homosexual men. Female drug users, patients with less than a high school education, African Americans, and Hispanics were less likely to have early access to HAART, compared to homosexual men, individuals who had completed college or had graduate education, and non-Hispanic whites, respectively.

Moreover, the research showed that patients who had higher incomes, those who were tested for HIV at anonymous test sites, or individuals who said they were able to get medical appointments on the same day as requested were more likely to have early HAART access.

The scientists from the University of California at Los Angeles; the University of California at San Diego; the Veterans Affairs San Diego Health Care System; RAND Health; Rutgers University, New Jersey; and the Veterans Affairs Los Angeles Health Care System report their findings in the June 2000 issue of Health Services Research.

"Our results provide clear evidence of the substantial inequities within the HIV infected population in accessing early drug therapy," said Andersen. "One of the most important and disturbing findings was that African Americans are less than half as likely as whites to have early access to HAART. This finding suggests the pressing need to eliminate barriers to early drug therapy for this and other vulnerable populations."

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference: Health Serv Res 2000 Jun;35(2):389-416

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