Association of Race, Substance Abuse, and Health Insurance Coverage With Use of Highly Active Antiretroviral Therapy Among HIV-Infected Women, 2005
Association of Race, Substance Abuse, and Health Insurance Coverage With Use of Highly Active Antiretroviral Therapy Among HIV-Infected Women, 2005
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DOI：
10.2105/ajph.2008.158949
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发表时间：
2010-08-01
影响因子：
12.7
通讯作者：
Wilson, Tracey E.
中科院分区：
文献类型：
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作者：
Lillie-Blanton, Marsha;Stone, Valerie E.;Wilson, Tracey E.
目标。我们使用妇女跨机构艾滋病毒研究（WIHS）的数据，研究了高活性抗逆转录病毒治疗（HAART）使用中的种族/民族差异，以及这种差异是否受到药物使用或保险状况的影响。Logistic回归分析了2005年临床指征HAART的女性纵向队列（N=1354）的HAART使用情况。每10名符合条件的妇女中约有3人报告未接受HAART治疗。非裔美国人和西班牙裔妇女比白人妇女更不可能使用HAART。在我们调整了潜在的混杂因素后，非裔美国妇女不使用HAART的可能性较高，而西班牙裔妇女则没有。没有保险和私人保险的妇女，无论种族/民族，使用HAART的可能性低于医疗补助计划的参保者。尽管酒精使用与HAART不使用有关，但非法药物使用与HAART不使用无关。这些发现表明，扩大和改善保险覆盖范围应该增加不同种族/民族群体获得抗逆转录病毒治疗的机会，但是不太可能消除非洲裔美国人和感染艾滋病毒/艾滋病的白人妇女在使用HAART方面的差距。[J] .中华卫生杂志，2010;31(2):393 - 399。doi: 10.2105 / AJPH.2008.158949)
Objectives. We examined racial/ethnic disparities in highly active antiretroviral therapy (HAART) use and whether differences are moderated by substance use or insurance status, using data from the Women's Interagency HIV Study (WIHS).Methods. Logistic regression examined HAART use in a longitudinal cohort of women for whom HAART was clinically indicated in 2005 (N=1354).Results. Approximately 3 of every 10 eligible women reported not taking HAART. African American and Hispanic women were less likely than were White women to use HAART. After we adjusted for potential confounders, the higher likelihood of not using HAART persisted for African American but not for Hispanic women. Uninsured and privately insured women, regardless of race/ethnicity, were less likely than were Medicaid enrollees to use HAART. Although alcohol use was related to HAART nonuse, illicit drug use was not.Conclusions. These findings suggest that expanding and improving insurance coverage should increase access to antiretroviral therapy across racial/ethnic groups, but it is not likely to eliminate the disparity in use of HAART between African American and White women with HIV/AIDS. (Am J Public Health. 2010; 100:1493-1499. doi:10.2105/AJPH.2008.158949)