Association of race, substance abuse, and health insurance coverage with use of highly active antiretroviral therapy among HIV-infected women, 2005.
OBJECTIVE
We examined racial/ethnic disparities in highly active antiretroviral therapy (HAART) use and whether differences are moderated by substance use or insurance status, using data from the Women's Interagency HIV Study (WIHS).


METHODS
Logistic regression examined HAART use in a longitudinal cohort of women for whom HAART was clinically indicated in 2005 (N = 1354).


RESULTS
Approximately 3 of every 10 eligible women reported not taking HAART. African American and Hispanic women were less likely than were White women to use HAART. After we adjusted for potential confounders, the higher likelihood of not using HAART persisted for African American but not for Hispanic women. Uninsured and privately insured women, regardless of race/ethnicity, were less likely than were Medicaid enrollees to use HAART. Although alcohol use was related to HAART nonuse, illicit drug use was not.


CONCLUSIONS
These findings suggest that expanding and improving insurance coverage should increase access to antiretroviral therapy across racial/ethnic groups, but it is not likely to eliminate the disparity in use of HAART between African American and White women with HIV/AIDS.
Lillie-Blanton
Marsha
M
Department of Health Policy, George Washington University, Washington, DC 20006, USA. lblanton@gwu.edu
Stone
Valerie E
VE
Snow Jones
Alison
A
Levi
Jeffrey
J
Golub
Elizabeth T
ET
Cohen
Mardge H
MH
Hessol
Nancy A
NA
Wilson
Tracey E
TE
D000328:Adult; D001741:Black or African American / Q000208:ethnology; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000208:ethnology; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics*; D016015:Logistic Models; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D055118:Medication Adherence / Q000208:ethnology*; D008875:Middle Aged; D015999:Multivariate Analysis; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology; D016903:Drug Monitoring