Is access to medical care associated with receipt of HIV testing and counselling ?
Lack of timely HIV testing leads to missed prevention opportunities and poor prevention counselling may be related to further disease spread.
We examined the association of self-reported access to medical care with receiving HIV testing and preventive counselling services among a sample of patients with HIV disease prior to hospitalization.
We conducted a cross-sectional interview of 217 Los Angeles patients hospitalized with HIV-related illness between 1992 and 1993 and abstracted clinical data from the medical record.
Eighty-four per cent of patients received HIV testing prior to hospitalization, but only 33% received preventive counselling services.
Only 48% of all patients rated outpatient medical care as somewhat or very easy to obtain.
Controlling for severity of illness, better access to outpatient medical care (OR=1.48 ; 95% CI=1.02-2.15), having a regular source of care (OR=3.40 ; 95% CI=1.29-8.97) and non-homosexual mode of HIV transmission (OR=0.31 ; 0.12-0.83) were associated with receiving HIV testing services prior to hospitalization.
Having a regular source of care (OR=3.55 ; 95% CI=1.37-9.22), being VA (Veterans'Administration) insured (OR=6.16 ; 1.46-26.05), older age (OR=0.95 ; 95% CI=0.90-0.99) and having a CD4 count between 101-200 (OR=0.19 ; 95% CI=0.06-0.63) were associated with receiving HIV counselling.
Limited self-reported access to medical care is associated with fewer patients receiving HIV testing and counselling. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Prévention, Utilisation, Service santé, Démographie, Etats Unis, Amérique du Nord, Amérique, Homme, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Prevention, Use, Health service, Demography, United States, North America, America, Human, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0488202
Code Inist : 002B30A03A. Création : 19/02/1999.