Insurance coverage, usual source of care, and receipt of clinically indicated care for comorbid conditions among adults living with human immunodeficiency virus

Risë B. Goldstein, Mary Jane Rotheram-Borus, Mallory O. Johnson, Lance S. Weinhardt, Robert H. Remien, Marguerita Lightfoot, Sheryl L Catz, Cheryl Gore-Felton, Sheri Kirshenbaum, Stephen F. Morin

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Background and Objectives: Associations of insurance coverage and source of care with use of human immunodeficiency virus (HIV)-related health, mental health, and substance abuse services are examined in a large, diverse, highly active antiretroviral therapy-era cohort. Methods: Adults who were infected with HIV (n = 3818) were interviewed in clinics and community agencies in Los Angeles, Milwaukee, New York, and San Francisco regarding drug use behaviors, health status, and health care utilization. Results: Most participants were insured by Medicaid. During the previous 3 months, 90% of privately insured, 87% of publicly insured, and 78% of uninsured participants had visited any provider. Publicly and privately insured participants were similar in receipt of antiretrovirals, prophylaxis against Pneumocystis carinii pneumonia, substance abuse services, and antidepressants. Uninsured participants were less likely to receive antiretrovirals but were more likely to use substance abuse services. Participants with no usual source of care were less likely to receive PCP prophylaxis. Conclusions: A lack of insurance is associated with barriers to care, but the advantage of private over public coverage appears smaller than in previous studies. PCP prophylaxis, substance abuse treatment, and antidepressants remain markedly underutilized. Educational initiatives about these treatments targeting providers and patients are indicated.

Original languageEnglish (US)
Pages (from-to)401-410
Number of pages10
JournalMedical Care
Volume43
Issue number4
DOIs
StatePublished - Apr 2005
Externally publishedYes

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Keywords

  • Addiction treatment
  • Antidepressants
  • Antiretroviral therapy
  • Comorbidity
  • HIV
  • Pneumocystis carinii pneumonia prophylaxis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Goldstein, R. B., Rotheram-Borus, M. J., Johnson, M. O., Weinhardt, L. S., Remien, R. H., Lightfoot, M., Catz, S. L., Gore-Felton, C., Kirshenbaum, S., & Morin, S. F. (2005). Insurance coverage, usual source of care, and receipt of clinically indicated care for comorbid conditions among adults living with human immunodeficiency virus. Medical Care, 43(4), 401-410. https://doi.org/10.1097/01.mlr.0000156850.86917.f8