National Healthcare Disparities Report - LDI Health Economist

Effectiveness of Care
Undocumented immigrants face an even greater challenge in accessing care and information regarding HIV
and AIDS, but data are limited on HIV infection rates of undocumented immigrants (Carrillo & DeCarlo,
2003). In 2007, HIV/AIDS was the fourth leading cause of death among Hispanic men and women ages 35-
44 (CDC, 2011b). Having Medicaid and a usual source of care decreased the likelihood of delaying care for
HIV, but research shows that delay in care is still greater for Hispanics and Blacks (Turner, et al., 2000).
Another group that is severely affected by HIV includes gay, bisexual, and other men who have sex with men
(MSM). MSM represent 2% of the U.S. population and the only risk group in which new HIV infections
have been gradually increasing since the 1990s. MSM have constantly represented the largest percentage of
people diagnosed with AIDS and persons with an AIDS diagnosis who have died. In 2009, MSM accounted
for more than half (61%) of all new HIV infections in the United States (CDC, 2011d).
The White House Office of National AIDS Policy launched the National HIV/AIDS Strategy (NHAS) in
July 2010. The NHAS is a comprehensive plan focused on: (1) reducing the number of people who become
infected with HIV, (2) increasing access to care and optimizing health outcomes for people living with HIV,
and (3) reducing HIV-related health disparities. The plan will serve as a roadmap for policymakers, partners
in prevention, and the public on steps the United States must take to lower HIV incidence, get people living
with HIV into care, and reduce HIV-related health disparities.
Measures
This year, a measure is presented on HIV testing, and five supporting measures are presented on the
prevention of opportunistic infections in HIV patients:
Chapter 2 HIV and AIDS
n Adult HIV patients who had at least two outpatient visits during the year.
n Adult HIV patients who received two or more CD4 tests during the year.
n Adult HIV patients who received highly active antiretroviral therapy (HAART).
n Eligible patients receiving prophylaxis for Pneumocystis pneumonia (PCP).
n Eligible patients receiving prophylaxis for Mycobacterium avium complex (MAC).
In addition, a measure is included on HIV infection deaths.
Findings
NEW
Prevention: HIV Testing
According to CDC, approximately 20% of the 1.2 million people living with HIV are unaware of their
infection (CDC, 2011d). CDC recommends routine voluntary HIV testing as part of normal medical practice
in all health care settings (Branson, et al., 2006). HIV infection is a serious health disorder that can be
diagnosed before symptoms develop. HIV can be detected by reliable, inexpensive, and noninvasive
screening tests. Although blood donations are routinely tested for HIV, it is important to track HIV testing in
a health care setting to determine the impact of preventive care for the population. HIV-infected patients have
years to gain if treatment is initiated early, before symptoms develop.
National Healthcare Disparities Report, 2011
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