title: Trends in the location of the HIV-positive population in Australia: implications for access to healthcare services and delivery.
abstract: BACKGROUND
  Examining existing and potential trends in the HIV-positive population in Australia is important for current and future healthcare service development and delivery.
  
  
  METHODS
  A new analysis of existing data on this population from the HIV Futures 5 survey was based on linking a geographic breakdown of respondents based on 'area type'--capital city or inner suburban, outer suburban, regional centre and rural--with patterns of healthcare service access. In addition, the distance between the postcode of the respondent's residence and the postcode of the doctor seen for HIV-related treatment was calculated. An analysis of 'area type' by income and age was also conducted.
  
  
  RESULTS
  The 'area type' analysis showed important differences in patterns of access to antiretroviral prescriptions and choice of provider for HIV-related and general healthcare. The median distance travelled to see a doctor for HIV-related treatment was higher for those living in outer suburbs than those living in regional centres.
  
  
  CONCLUSIONS
  Differences in service use appear to be related to geographic accessibility of different service types. However, there may be other important social, economic and cultural factors involved. Ageing and socio-economic pressures may be influencing a move away from inner suburban areas where most HIV-specific care is located. This new analysis assists in finding the right balance between increasing the accessibility of HIV-specific services and 'mainstreaming'. Longitudinal data collection would further assist in tracking trends in geographic location, and how often and at what intervals people living with HIV utilise healthcare services.
authors.affiliation: Australian Research Centre in Sex, Health and Society, LaTrobe University, 1st Floor, 215 Franklin Street, Melbourne, Vic. 3000, Australia. m.carman@latrobe.edu.au
authors.forename: Marina
authors.initials: M
authors.lastname: Carman
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Grierson
authors.forename: Marian
authors.initials: M
authors.lastname: Pitts
authors.forename: Michael
authors.initials: M
authors.lastname: Hurley
authors.forename: Jennifer
authors.initials: J
authors.lastname: Power
mesh_terms: D001315:Australia / Q000453:epidemiology; D003156:Community Mental Health Services / Q000639:trends*; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000628:therapy*; D006297:Health Services Accessibility / Q000706:statistics & numerical data* / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011320:Primary Health Care / Q000458:organization & administration; D012111:Residence Characteristics; D012959:Socioeconomic Factors