Health Services Use by Urban Women With or at Risk for HIV-1 Infection: The HIV Epidemiology Research Study (HERS)

作者：Liza Solomon, Michael D. Stein, Colin P. Flynn, Paula C. Schuman, Ellie E. Schoenbaum, Janet S. Moore, Scott D. Holmberg, Neil M.H. Graham · 发表于：Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology · 年份：1998 · DOI：10.1097/00042560-199803010-00011 · 被引用次数：115 · 研究领域：HIV/AIDS Research and Interventions、Pneumocystis jirovecii pneumonia detection and treatment、HIV, Drug Use, Sexual Risk

OBJECTIVE: To characterize health services use by urban women with or at risk for HIV-1 infection enrolled in a prospective multicenter study. METHODS: 1310 women 16 to 55 years of age who were at risk for HIV-1 infection were recruited between April 1993 and January 1995 at four urban centers (Baltimore, Maryland; The Bronx, New York; Detroit, Michigan; and Providence, Rhode Island). HIV-1-seropositive women without AIDS-defining illness were oversampled in a ratio of 2:1 in comparison with HIV-1-seronegative women. At a baseline study visit, the women received physical and laboratory examinations, including CD4+ counts, and were interviewed regarding HIV risk behavior, health services use, and clinical data. RESULTS: 863 women were HIV-1-seropositive and 430 were HIV-1-seronegative. Fifty-two percent of the women reported injection drug use (IDU) since 1985, and 48% acquired HIV through sexual contact. Seventy-seven percent were African American, 23% were white, and 16% were Hispanic. The median age was 35 years. HIV-seronegative women were significantly less likely to have health insurance (19%) than were HIV-seropositive women (30%; p < .001). Among the HIV-seropositive women, 68% had CD4+ cell counts of <500/microl, and 64% were asymptomatic. Sixty-four percent of the HIV-seronegative women had had an outpatient hospital visit in the past 6 months, as had 86% of HIV-seropositive women (p < 0.001). Hospitalization in the past 6 months was also higher in HIV-seropositive w...