title: Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
abstract: OBJECTIVE
  We examined racial/ethnic differences in prenatal antiretroviral (ARV) treatment among 3259 HIV-infected pregnant Medicaid enrollees.
  
  
  METHODS
  We analyzed 2005-2007 Medicaid claims data from 14 southern states, comparing rates of not receiving ARVs and suboptimal versus optimal ARV therapy.
  
  
  RESULTS
  More than one third (37.3%) had zero claims for ARV drugs. Three quarters (73.4%) of 346 Hispanic women received no prenatal ARVs. After we adjusted for covariates, Hispanic women had 3.89 (95% confidence interval = 2.58, 5.87) times the risk of not receiving ARVs compared with Whites. Hispanic women often had only 1 or 2 months of Medicaid eligibility, perhaps associated with barriers for immigrants. Less than 3 months of eligibility was strongly associated with nontreatment (adjusted odds ratio = 29.0; 95% confidence interval = 13.4, 62.7).
  
  
  CONCLUSIONS
  Optimal HIV treatment rates in pregnancy are a public health priority, especially for preventing transmission to infants. Medicaid has the surveillance and drug coverage to ensure that all HIV-infected pregnant women are offered treatment. States that offer emergency Medicaid coverage for only delivery services to pregnant immigrants are missing an opportunity to screen, diagnose, and treat pregnant women with HIV, and to prevent HIV in children.
authors.affiliation: Shun Zhang and George Rust are with the National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA. Charles Senteio is with the University of Michigan, School of Information, Ann Arbor. Jesus Felizzola is with the AIDS Education and Training Center, National Center for HIV Care in Minority Communities, HealthHIV, Washington, DC.
authors.forename: Shun
authors.initials: S
authors.lastname: Zhang
authors.forename: Charles
authors.initials: C
authors.lastname: Senteio
authors.forename: Jesus
authors.initials: J
authors.lastname: Felizzola
authors.forename: George
authors.initials: G
authors.lastname: Rust
mesh_terms: D000328:Adult; D001741:Black or African American; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D008484:Medicaid; D016017:Odds Ratio; D011247:Pregnancy; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents