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. 2000 Jul;90(7):1138–1140. doi: 10.2105/ajph.90.7.1138

Delays in seeking HIV care due to competing caregiver responsibilities.

M D Stein 1, S Crystal 1, W E Cunningham 1, A Ananthanarayanan 1, R M Andersen 1, B J Turner 1, S Zierler 1, S Morton 1, M H Katz 1, S A Bozzette 1, M F Shapiro 1, M A Schuster 1
PMCID: PMC1446306  PMID: 10897195

Abstract

OBJECTIVES: This study sought to describe the characteristics of HIV-infected persons who delay medical care for themselves because they are caring for others. METHODS: HIV-infected adults (n = 2864) enrolled in the HIV Cost and Services Utilization Study (1996-1997) were interviewed. RESULTS: The odds were 1.6 times greater for women than for men to put off care (95% confidence interval [CI] = 1.2, 2.2); persons without insurance and with CD4 cell counts above 500 were also significantly more likely to put off care. Having a child in the household was associated with putting off care (odds ratio [OR] = 1.8, 95% CI = 1.4, 2.3). CONCLUSIONS: Women or individuals with a child in the household should be offered services that might allow them to avoid delays in seeking their own medical care.

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Selected References

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  1. Andersen R. M. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995 Mar;36(1):1–10. [PubMed] [Google Scholar]
  2. Bozzette S. A., Berry S. H., Duan N., Frankel M. R., Leibowitz A. A., Lefkowitz D., Emmons C. A., Senterfitt J. W., Berk M. L., Morton S. C. The care of HIV-infected adults in the United States. HIV Cost and Services Utilization Study Consortium. N Engl J Med. 1998 Dec 24;339(26):1897–1904. doi: 10.1056/NEJM199812243392606. [DOI] [PubMed] [Google Scholar]
  3. Chu S. Y., Buehler J. W., Berkelman R. L. Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States. JAMA. 1990 Jul 11;264(2):225–229. [PubMed] [Google Scholar]
  4. Cohen F. L., Nehring W. M. Foster care of HIV-positive children in the United States. Public Health Rep. 1994 Jan-Feb;109(1):60–67. [PMC free article] [PubMed] [Google Scholar]
  5. Cu-Uvin S., Flanigan T. P., Rich J. D., Mileno M. D., Mayer K. H., Carpenter C. C. Human immunodeficiency virus infection and acquired immunodeficiency syndrome among North American women. Am J Med. 1996 Sep;101(3):316–322. doi: 10.1016/S0002-9343(96)00063-0. [DOI] [PubMed] [Google Scholar]
  6. Folkman S., Chesney M. A., Christopher-Richards A. Stress and coping in caregiving partners of men with AIDS. Psychiatr Clin North Am. 1994 Mar;17(1):35–53. [PubMed] [Google Scholar]
  7. Johnston D., Stall R., Smith K. Reliance by gay men and intravenous drug users on friends and family for AIDS-related care. AIDS Care. 1995;7(3):307–319. doi: 10.1080/09540129550126533. [DOI] [PubMed] [Google Scholar]
  8. Kissinger P., Cohen D., Brandon W., Rice J., Morse A., Clark R. Compliance with public sector HIV medical care. J Natl Med Assoc. 1995 Jan;87(1):19–24. [PMC free article] [PubMed] [Google Scholar]
  9. Moore R. D., Hidalgo J., Sugland B. W., Chaisson R. E. Zidovudine and the natural history of the acquired immunodeficiency syndrome. N Engl J Med. 1991 May 16;324(20):1412–1416. doi: 10.1056/NEJM199105163242006. [DOI] [PubMed] [Google Scholar]
  10. Samet J. H., Freedberg K. A., Stein M. D., Lewis R., Savetsky J., Sullivan L., Levenson S. M., Hingson R. Trillion virion delay: time from testing positive for HIV to presentation for primary care. Arch Intern Med. 1998 Apr 13;158(7):734–740. doi: 10.1001/archinte.158.7.734. [DOI] [PubMed] [Google Scholar]
  11. Schable B., Diaz T., Chu S. Y., Caldwell M. B., Conti L., Alston O. M., Sorvillo F., Checko P. J., Hermann P., Davidson A. J. Who are the primary caretakers of children born to HIV-infected mothers? Results from a multistate surveillance project. Pediatrics. 1995 Apr;95(4):511–515. [PubMed] [Google Scholar]
  12. Shapiro M. F., Morton S. C., McCaffrey D. F., Senterfitt J. W., Fleishman J. A., Perlman J. F., Athey L. A., Keesey J. W., Goldman D. P., Berry S. H. Variations in the care of HIV-infected adults in the United States: results from the HIV Cost and Services Utilization Study. JAMA. 1999 Jun 23;281(24):2305–2315. doi: 10.1001/jama.281.24.2305. [DOI] [PubMed] [Google Scholar]
  13. Smith D. K., Warren D. L., Vlahov D., Schuman P., Stein M. D., Greenberg B. L., Holmberg S. D. Design and baseline participant characteristics of the Human Immunodeficiency Virus Epidemiology Research (HER) Study: a prospective cohort study of human immunodeficiency virus infection in US women. Am J Epidemiol. 1997 Sep 15;146(6):459–469. doi: 10.1093/oxfordjournals.aje.a009299. [DOI] [PubMed] [Google Scholar]
  14. Stein M. D., Piette J., Mor V., Wachtel T. J., Fleishman J., Mayer K. H., Carpenter C. C. Differences in access to zidovudine (AZT) among symptomatic HIV-infected persons. J Gen Intern Med. 1991 Jan-Feb;6(1):35–40. doi: 10.1007/BF02599388. [DOI] [PubMed] [Google Scholar]
  15. Stone R., Cafferata G. L., Sangl J. Caregivers of the frail elderly: a national profile. Gerontologist. 1987 Oct;27(5):616–626. doi: 10.1093/geront/27.5.616. [DOI] [PubMed] [Google Scholar]
  16. Turner B. J., Markson L. E., McKee L. J., Houchens R., Fanning T. Health care delivery, zidovudine use, and survival of women and men with AIDS. J Acquir Immune Defic Syndr. 1994 Dec;7(12):1250–1262. [PubMed] [Google Scholar]
  17. Turner H. A., Catania J. A., Gagnon J. The prevalence of informal caregiving to persons with AIDS in the United States: caregiver characteristics and their implications. Soc Sci Med. 1994 Jun;38(11):1543–1552. doi: 10.1016/0277-9536(94)90116-3. [DOI] [PubMed] [Google Scholar]

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