Effect of race on insurance coverage and health service use for HIV-infected gay men

Objective: To determine whether race is associated with health insurance co verage and health service use among gay and bisexual men in the Baltimore c enter of the Multicenter AIDS Cohort Study. Methods: Data from eight semiannual study visits between 1991 and 1996 were used. Descriptive, stratified, and logistic regression analyses were condu cted to determine whether race is associated with insurance coverage, medic al, or dental service use, after controlling for socioeconomic variables. Results: No difference was found between blacks' and whites' likelihood of having health insurance, private insurance, using inpatient, emergency depa rtment services, or antiretroviral medications. Whites were more likely to use outpatient services, particularly if CD4 cell counts were high, and wer e more likely to use dental services, although blacks were more likely to h ave dental insurance. Conclusions: Further research must be conducted to examine cultural, social , and psychological factors that help explain why white gay men use more ou tpatient and dental services, when other service use is unrelated to race. Investigators should be precise when using race as a variable in health ser vices and epidemiologic research, emphasizing when racial differences truly exist versus when the variable race is a surrogate for another factor.