THE USE OF HEALTH-SERVICES BY WOMEN WITH HIV-INFECTION

Objective. The purpose of this study is to determine whether women who have been diagnosed with HIV utilize the same volume of medical care services as men who have been diagnosed with HIV. Data Sources. This s tudy uses data from the first wave of interviews of the AIDS Cost and Service Utilization Survey (ACSUS) conducted between May and July of 1 99 1. The first wave of interviews involved 1,949 adults and adolescen ts, of whom 359 were women. Study Design. The ACSUS sample was selecte d from 26 sites (hospitals, clinics, and physician offices) in ten cit ies chosen from the 25 cities with the most AIDS cases. Cities are loc ated throughout the nation, and in low, medium, and high prevalence ar eas. The sites in each city are generally those that treat the highest number of persons with HIV infection. Patients at each site were chos en using disease stage (asymptomatic, symptomatic, and AIDS) and gende r as the selection criteria. Utilization equations are estimated for A ZT use, outpatient care, and hospitalization. Data Collection. The ACS US involves six in-person interviews over an 18-month period. Intervie ws include questions about the use of medical and support services, in surance status, functional status, and barriers to care during the pri or three-month period. Principal Findings. A male injection drug user (IDU) with AIDS is 20 percent more likely to be hospitalized than a wo man with AIDS, and the hospital cost of treating a male IDU with AIDS is $9,180 more per year than the hospital cost of treating a woman wit h AIDS. Conclusions. This study shows that, even after being diagnosed and after having accessed the medical care system, women with AIDS re ceive fewer services than men with AIDS.