In France, the entire population theoretically has access to health coverage, but in fact a section of the poorest population does not.

Institutions have therefore been set up to provide medical care for the destitute.

The objectives of this study were to describe the social characteristics of the HIV-positive destitute population attending an outpatient clinic providing free health care for the destitute in a Paris University Hospital, to compare their clinical-epidemiological characteristics with those of non-destitute HIV-positive patients, and to evaluate the quality of their care.

We performed a historical prospective study wherein a cohort of 115 HIV-positive destitute patients (defined as having no health coverage at their first consultation) was compared with a control cohort of 183 HIV-positive non-destitute patients attending the same clinic.

Ninety-five per cent of the destitute patients had no stable employment, 32% had no source of income, 75% had no permanent residence and 27% were IV drug abusers.

Fifty-nine per cent were foreigners, most of whom had legal residence papers and had been in France for more than 3 years.

When comparing the control and the destitute groups, the latter had a three times greater risk of developing tuberculosis (RH=3.2, CI 95%=[1.1-9.4]). Medical compliance, access to antiretroviral treatment and hospitalization were identical in both groups. (...)