Access to and utilization of primary care services among HIV-infected women

Objectives: To identify factors associated with the use of medical services , and to test a model of access to care, among HIV-infected women. Methods: A cross-sectional telephone survey was administered to 213 HIV-inf ected women. Outcomes were having a primary care provider, and use of prima ry care and emergency health services. Predictors included characteristics of the population-at-risk and of the health care system. Results: Ninety-three percent of respondents had a primary care provider. L inear regression found age >45 years (p = .002), perceiving greater barrier s to getting to a clinic (p = .04) and greater benefits from medications (p = .03), lack of problems with appointment times (p = .02), having AIDS (p = .01), shorter appointment waiting rimes (p = .0003), and greater cost of travel to care (p = .001) were associated with a greater number of primary care visits. Thirty-seven percent missed at least 1 primary care appointmen t. In logistic regression, lack of insurance (odds ratio [OR] = 2.76), curr ent injection drug use (OR = 2.89) and difficulty remembering appointments (OR = 2.36) were associated with having missed any appointments. Conclusions: Characteristics of the population-at-risk and of the health ca re system both make important contributions to primary care service use.