Medicina clinica · 2003
[Health services utilization according to gender in a cohort of intravenous drug users infected with HIV].
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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García de la Hera Manuela, Ruiz Isabel, Pérez-Hoyos Santiago, Hernández Aguado Ildefonso
Аннотация
BACKGROUND AND OBJECTIVE: Gender differences among HIV infected persons have been described in the utilization of health-care services and in their access to anti-retroviral and prophylactic treatments. The aim of this study was to determine the characteristics of the health service utilization according to gender in a cohort of intravenous drug users (IVDU) with HIV infection.
PATIENTS AND METHOD: Prospective cohort study of 926 IVDU who tested positive for HIV infection in their first visit between January 1987 and December 1996. These participants generated 3,429 visits in different health-care centers. Odds ratio (OR) and their 95% confidence intervals (95%CI) were estimated by multiple logistic regression analysis using robust methods.
RESULTS: Out of 926 subjects, 25.4% were women. Although there were not clear differences by sex in the use of health-care centers, we observed that since the introduction of highly active antiretroviral treatments (HAART) men have had fewer hospital admission than women (OR = 0.50; 95%CI: 0.25-0.99). Moreover, once HAART was started, men received higher prescriptions of antiretroviral treatment than women (OR = 1.30; 95%CI: 0.97-1.24), as well as a higher number of prescriptions for prevention of tuberculosis (OR = 2.22; 95%CI: 1.24-4.16) and Pneumocystis carinii pneumonia (PCP) (OR = 1.50; 95%CI: 1.17-1.91). These associations were attenuated when sociodemographic and clinical status variables were taken into account, except for PCP treatment.
CONCLUSION: No relevant differences according to gender were observed in the care of HIV disease. The benefits of HAART may have a minor impact among women in the short term, depending on prescriptions and the other variables considered. These findings must be confirmed by studies with longer follow-up periods.
PATIENTS AND METHOD: Prospective cohort study of 926 IVDU who tested positive for HIV infection in their first visit between January 1987 and December 1996. These participants generated 3,429 visits in different health-care centers. Odds ratio (OR) and their 95% confidence intervals (95%CI) were estimated by multiple logistic regression analysis using robust methods.
RESULTS: Out of 926 subjects, 25.4% were women. Although there were not clear differences by sex in the use of health-care centers, we observed that since the introduction of highly active antiretroviral treatments (HAART) men have had fewer hospital admission than women (OR = 0.50; 95%CI: 0.25-0.99). Moreover, once HAART was started, men received higher prescriptions of antiretroviral treatment than women (OR = 1.30; 95%CI: 0.97-1.24), as well as a higher number of prescriptions for prevention of tuberculosis (OR = 2.22; 95%CI: 1.24-4.16) and Pneumocystis carinii pneumonia (PCP) (OR = 1.50; 95%CI: 1.17-1.91). These associations were attenuated when sociodemographic and clinical status variables were taken into account, except for PCP treatment.
CONCLUSION: No relevant differences according to gender were observed in the care of HIV disease. The benefits of HAART may have a minor impact among women in the short term, depending on prescriptions and the other variables considered. These findings must be confirmed by studies with longer follow-up periods.