Ryan White HIV/AIDS Program Assistance and HIV Treatment Outcomes
| Autor: | Antigone Dempsey, Abigail H. Viall, Heather Hauck, Jacek Skarbinski, Heather Bradley, Pascale M. Wortley |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Adolescent HIV Infections Article Young Adult 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Health care Patient Protection and Affordable Care Act Humans Medicine 030212 general & internal medicine Young adult Medical prescription business.industry Medical record Middle Aged medicine.disease 030112 virology United States Underinsured Treatment Outcome Infectious Diseases Family medicine Physical therapy Female business Medicaid |
| Zdroj: | Clinical Infectious Diseases. 62:90-98 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/civ708 |
| Popis: | BACKGROUND The Ryan White HIV/AIDS Program (RWHAP) provides persons infected with human immunodeficiency virus (HIV) with services not covered by other healthcare payer types. Limited data exist to inform policy decisions about the most appropriate role for RWHAP under the Patient Protection and Affordable Care Act (ACA). METHODS We assessed associations between RWHAP assistance and antiretroviral therapy (ART) prescription and viral suppression. We used data from the Medical Monitoring Project, a surveillance system assessing characteristics of HIV-infected adults receiving medical care in the United States. Interview and medical record data were collected in 2009-2013 from 18 095 patients. RESULTS Nearly 41% of patients had RWHAP assistance; 15% relied solely on RWHAP assistance for HIV care. Overall, 91% were prescribed ART, and 75% were virally suppressed. Uninsured patients receiving RWHAP assistance were significantly more likely to be prescribed ART (52% vs 94%; P < .01) and virally suppressed (39% vs 77%; P < .01) than uninsured patients without RWHAP assistance. Patients with private insurance and Medicaid were 6% and 7% less likely, respectively, to be prescribed ART than those with RWHAP only (P < .01). Those with private insurance and Medicaid were 5% and 12% less likely, respectively, to be virally suppressed (P ≤ .02) than those with RWHAP only. Patients whose private or Medicaid coverage was supplemented by RWHAP were more likely to be prescribed ART and virally suppressed than those without RWHAP supplementation (P ≤ .01). CONCLUSIONS Uninsured and underinsured HIV-infected persons receiving RWHAP assistance were more likely to be prescribed ART and virally suppressed than those with other types of healthcare coverage. |
| Databáze: | OpenAIRE |
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