title: Socioeconomic disparities in access to HIV/AIDS treatment programs in resource-limited settings.
abstract: This study employs data from rural South Africa to determine whether there were socioeconomic differences in the profile of HIV-infected persons living in the community and HIV-infected patients presenting for hospital-based outpatient HIV/AIDS care and related services. There were 776 HIV-infected persons aged 18-35 years in Limpopo Province, South Africa who were included in the study, including 534 consecutive patients who presented for care at a hospital-based outpatient HIV clinic, and 242 persons living in the community. Persons seen in clinic had a higher overall socioeconomic profile compared to the community sample. They were more likely to have completed matric or tertiary education (P=0.04), less likely to be unemployed (P<0.001), and more likely to live in households with access to a private tap water supply (P<0.001). These differences persisted after multivariable adjustment. Our findings demonstrate that important socioeconomic differences in uptake of hospital-based HIV/AIDS care were identified among HIV-infected adults living in a rural region of South Africa. This suggests an important limitation in hospital-based HIV/AIDS care and underscores the need to monitor the equity implications of highly active antiretroviral therapy scale-up in resource-limited settings.
authors.affiliation: Langley Porter Psychiatric Institute, University of California at San Francisco, San Francisco, CA, USA. alexander.tsai@ucsf.edu
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Tsai
authors.forename: Mickey
authors.initials: M
authors.lastname: Chopra
authors.forename: Paul M
authors.initials: PM
authors.lastname: Pronyk
authors.forename: Neil A
authors.initials: NA
authors.lastname: Martinson
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D011204:Poverty Areas; D019035:Rural Health Services / Q000458:organization & administration; D012959:Socioeconomic Factors; D013019:South Africa; D055815:Young Adult