Characteristics of individuals infected with the human immunodeficiency virus and provider interaction in the predominantly rural Southeast.
BACKGROUND
This detailed study describes the demographic characteristics, behavioral characteristics, care-seeking behavior, and barriers to health care and social services for patients infected with the human immunodeficiency virus (HIV) in the Southeast.


METHODS
We conducted a cross-sectional study of Medicaid-eligible HIV-positive individuals (chart abstractions [N = 679], patient surveys [N = 487]) and care providers (N = 101) in North Carolina. Relative risks compare blacks, women, and respondents reporting substance abuse with their reference groups. Results are compared with those of a larger sample including persons from Alabama and South Carolina.


RESULTS
Forty-one percent of respondents did not receive care locally, and 69% of female respondents had young children at home. In the 12 months before the survey, 66% reported substance abuse; 49% reported multiple living situations; 11% had entered drug treatment; and 10% had difficulty with the law. The findings in North Carolina did not differ from those in Alabama and South Carolina. Mean indices from care provider surveys revealed low interagency knowledge and referrals.


CONCLUSIONS
Patients have complex needs for both social services and health care. However, providers are not working together.
Sanford Institute for Public Policy; Center for Health Policy, Law and Management, Duke University, Durham, NC, USA.
K
K
Whetten-Goldstein
T Q
TQ
Nguyen
A E
AE
Heald
D000328:Adult; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009657:North Carolina / Q000453:epidemiology; D011159:Population Surveillance; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012947:Social Work; D015144:Southeastern United States / Q000453:epidemiology