Background
Women with HIV infection have lagged behind men in receipt of critical health care,
but it is not known if those disparities are due in part to where women receive care.
We examined differences in care received by HIV-infected women and men in a national
sample of Ryan White CARE Act–funded clinics and explored the influence of clinic
characteristics on care quality.
Methods
Record review was done on a sample of 9,015 patients who received care at 69 CARE
Act–funded HIV primary care clinics that participated in a quality improvement study.
Outcome measures studied were highly active antiretroviral therapy (HAART) use, HIV
viral suppression, Pneumocystis jiroveci pneumonia (PCP) prophylaxis, screening, and other disease prevention efforts.
Results
Women were less likely than men to receive HAART (78% versus 82%, p < .001), receive PCP prophylaxis (65% versus 75%, p < .0001), or have their hepatitis C virus status known (87% versus 88%, p = .02) despite being seen more regularly (69% versus 66%, p = .04). Sites serving high percentages of women delivered similar or better care
for both men and women than other sites. Although sites serving a higher percent of
women had more support services such as case management and onsite obstetrician–gynecologists
and provided Pap smears at higher rates, women at such sites remained less likely
than men to receive important HIV care including HAART and PCP prophylaxis.
Conclusions
The gap in the quality of care provided to HIV-infected men and women in critical
areas persists, and is not explained by the types of sites where men and women receive
care.
Keywords
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Article info
Publication history
Accepted:
February 7,
2006
Received:
October 24,
2005
Identification
Copyright
© 2006 Jacobs Institute of Women’s Health. Published by Elsevier Inc. All rights reserved.
