Insurance coverage and access to HIV testing and treatment: Considerations for individuals at risk for infection and for those with undiagnosed infection
Insurance coverage and access to HIV testing and treatment: Considerations for individuals at risk for infection and for those with undiagnosed infection
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DOI：
10.1086/522547
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发表时间：
2007-12-15
影响因子：
11.8
通讯作者：
Levi, Jeffrey
中科院分区：
文献类型：
--
作者：
Kates, Jennifer;Levi, Jeffrey
疾病控制和预防中心估计，在美国约120万感染人类免疫缺陷病毒(HIV)或获得性免疫缺陷综合征的人中，约有50万人没有接受疾病治疗，其中包括约25万人不知道自己是HIV阳性患者。尽管人们对这两类艾滋病毒感染者知之甚少，但它们很可能反映了更多的艾滋病毒感染者；也就是说，与美国总人口相比，他们主要是少数族裔，更有可能失业和/或贫穷，更有可能没有保险或依赖公共保险计划，如医疗补助计划。此外，许多人在病程后期被诊断为艾滋病毒感染，那些难以接触到的人不太可能接受标准护理抗逆转录病毒治疗。新的检测计划试图诊断不知道自己艾滋病毒感染状况的人的感染情况，这引发了对当前系统处理新患者的资金和计划能力的重要问题。考虑到这些挑战和问题，衡量新测试计划的成功将是关键但困难的。
The Centers for Disease Control and Prevention estimates that of the similar to 1.2 million people with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome in the United States, similar to 500,000 are not receiving care for their disease, including similar to 250,000 who do not know they are HIV positive. Although little is known about these 2 subgroups of HIV-infected people, they are likely to be reflective of the larger population of people with HIV infection; that is, they are predominantly racial minorities, more likely to be unemployed and/or poor, and much more likely to be uninsured or dependent on public insurance programs such as Medicaid, compared with the US population overall. In addition, many persons receive a diagnosis of HIV infection late during the course of the disease, and those who are difficult to reach are less likely to receive standard-of-care antiretroviral therapy. New testing initiatives attempting to diagnose infection in persons who do not know their HIV infection status have raised important questions about the funding and program capacity of the current system to handle new patients. Given these challenges and questions, measuring the success of new testing initiatives will be critical but difficult.