Use of mammographic screening by HIV-infected women in the Women's Interagency HIV Study (WIHS).
BACKGROUND
Although HIV-positive women may be less likely than women in general to receive mammography due to socioeconomic disadvantage, HIV diagnosis may increase opportunities for medical interactions which encourage mammography.


METHODS
HIV-positive (2,059) and HIV-negative (569) Women's Interagency HIV Study (WIHS) participants reported ever/never history of mammography at baseline (in 1994, 1995) and, at each 6-month follow-up visit, if they had been screened since their last visit. National Health Interview Survey (NHIS) data for 1994 were used to compare WIHS participants to U.S. women. Factors independently related to mammography were determined using logistic regression for baseline data and proportional hazards for follow-up data. Results were adjusted for age.


RESULTS
Among women > or =40, fewer WIHS women, regardless of HIV status, reported screening than U.S. women (67% HIV-positive, 62% HIV-negative, 79% NHIS; P < 0.0001). First-time screening while on study was associated with being HIV-positive [rate ratio (95% confidence interval) = 1.6 (1.1, 2.3)]. Factors independently associated with screening were related to health care access and usage.


CONCLUSIONS
WIHS women, a disadvantaged population, reported less mammography than the general population. HIV-positive women reported more screening than HIV-negative women, possibly because of greater opportunity to interact with the health care system.
Preston-Martin
Susan
S
University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California 90033-0800, USA. spresto@hsc.usc.edu
Kirstein
Lynn M
LM
Pogoda
Janice M
JM
Rimer
Barbara
B
Melnick
Sandra
S
Masri-Lavine
Lena
L
Silver
Sylvia
S
Hessol
Nancy
N
French
Audrey L
AL
Feldman
Joseph
J
Sacks
Henry S
HS
Deely
Maureen
M
Levine
Alexandra M
AM
D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology