Medical treatment of women and adherence to HIV guidelines at an urban university-staffed public clinic.
BACKGROUND
HIV-related morbidity and mortality have declined in recent years in the United States. Relative to their male counterparts, however, HIV-infected women tend to have less reduced morbidity and mortality. The purpose of this study was to investigate if the reported small decreases in HIV-related morbidity and mortality in women could be due to their receiving a lesser standard of care from public health clinics.


METHODS
One hundred sixteen female and 131 male patients who were diagnosed with HIV infection were drawn consecutively from a county-owned health clinical database in Houston, Texas. Physicians from the two local medical schools staffed the clinic. Information on patients' demographic characteristics, screening tests, clinical care, and prophylaxis care was abstracted for comparison.


CONCLUSIONS
The data showed that there were no statistically significant sex-based differences in getting access to antiretroviral treatment or for prophylaxis of opportunistic infections in the clinic. Sex-based differences, however, were found in the initial CD4 cell count and HIV load. Women had higher CD4 cell counts and HIV RNA levels at the initial stage and during the time of treatment.
Parikh
Mihir J
MJ
Department of Family Practice & Community Medicine, Medical School, University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA. Mihir.J.Parikh@uth.tmc.edu
Cheng
Lee
L
Nieman
Linda Z
LZ
Grimes
Richard M
RM
D000046:Academic Medical Centers; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D018791:CD4 Lymphocyte Count; D003151:Community Health Centers / Q000458:organization & administration / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006297:Health Services Accessibility; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012737:Sex Factors; D013781:Texas; D017664:Uncompensated Care; D019562:Viral Load; D014932:Women's Health Services / Q000458:organization & administration / Q000592:standards*