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 study uses data from the first wave of interviews of the AIDS Cost and Service Utilization Survey (ACSUS) conducted between May and July of 1991. The first wave of interviews involved 1,949 adults and adolescents, of whom 359 were women.

STUDY DESIGN: The ACSUS sample was selected from 26 sites (hospitals, clinics, and physician offices) in ten cities chosen from the 25 cities with the most AIDS cases. Cities are located throughout the nation, and in low, medium, and high prevalence areas. The sites in each city are generally those that treat the highest number of persons with HIV infection. Patients at each site were chosen using disease stage (asymptomatic, symptomatic, and AIDS) and gender as the selection criteria. Utilization equations are estimated for AZT use, outpatient care, and hospitalization.

DATA COLLECTION: The ACSUS involves six in-person interviews over an 18-month period. Interviews include questions about the use of medical and support services, insurance status, functional status, and barriers to care during the prior three-month period.

PRINCIPAL FINDINGS: A male injection drug user (IDU) with AIDS is 20 percent more likely to be hospitalized than a woman 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 with AIDS.

CONCLUSIONS: This study shows that, even after being diagnosed and after having accessed the medical care system, women with AIDS receive fewer services than men with AIDS.