2023-09-28 14:46:10 +00:00
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abstract: 'HIV-infected people with low socioeconomic status (SES) and people who
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are members of a racial or ethnic minority have been found to receive
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fewer services, including treatment with Highly Active Antiretroviral
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Therapy (HAART), than others. We examined whether these groups also have
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worse survival than others and the degree to which service use and
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antiretroviral medications explain these disparities in a prospective
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cohort study of a national probability sample of 2,864 adults receiving
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HIV care. The independent variables were wealth (net accumulated
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financial assets), annual income, educational attainment, employment
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status (currently working or not working), race/ethnicity, insurance
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status, use of services, and use of medications at baseline. The main
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outcome variable was death between January 1996 and December 2000. The
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analysis was descriptive and multivariate adjusted Cox proportional
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hazards regression analysis of survival.
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By December 2000, 20\% (13\% from HIV, 7\% non-HIV causes) of the sample
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had died. Those with no accumulated financial assets had an 89\% greater
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risk of death (RR= 1.89, 95\% CI= 1.15-3.13) and those with less than a
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high school education had a 53\% greater risk of death (RR= 1.53, 95\%
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CI= 1.15-2.04) than their counterparts, after adjusting for
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sociodemographic and clinical variables only. Further adjusting for use
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of services and antiretroviral treatment diminished, but did not
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eliminate, the elevated relative risk of death for those with low SES by
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three of the four measures. The finding of markedly elevated relative
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risks of death for those with HIV infection and low SES is of particular
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concern given the disproportionate rates of HIV infection in these
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groups. Effective interventions are needed to improve outcomes for low
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SES groups with HIV infection.'
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affiliation: 'Cunningham, WE (Corresponding Author), Univ Calif Los Angeles, Sch Publ
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Hlth, Ctr Hlth Sci, 10833 Le Conte Ave,Rm 31-254A, Los Angeles, CA 90095 USA.
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Univ Calif Los Angeles, Div Gen Internal Med \& Hlth Serv Res, Dept Med, Los Angeles,
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CA 90024 USA.
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Univ Calif Los Angeles, Dept Hlth Serv, Sch Publ Hlth, Los Angeles, CA 90024 USA.
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RAND Corp, Hlth Sci Program, Santa Monica, CA 90406 USA.
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RAND Corp, Dept Psychiat \& Biobehav Sci, Santa Monica, CA 90406 USA.'
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author: Cunningham, WE and Hays, RD and Duan, NH and Andersen, RM and Nakazono, TT
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and Bozzette, SA and Shapiro, MF
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author-email: wcunningham@mednet.ucla.edu
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author_list:
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- family: Cunningham
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given: WE
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- family: Hays
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given: RD
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- family: Duan
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given: NH
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- family: Andersen
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given: RM
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- family: Nakazono
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given: TT
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- family: Bozzette
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given: SA
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- family: Shapiro
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given: MF
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da: '2023-09-28'
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eissn: 1548-6869
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files: []
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issn: 1049-2089
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journal: JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED
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keywords: HIV; AIDS; socioeconomic status; health services; outcomes; survival
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keywords-plus: 'ACTIVE ANTIRETROVIRAL THERAPY; AIDS; ACCESS; ADULTS; HEALTH; MORTALITY;
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PREVALENCE; PREDICTORS; DISEASE; DEATH'
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language: English
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month: NOV
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number: '4'
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number-of-cited-references: '40'
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orcid-numbers: 'Hays, Ron D./0000-0001-6697-907X
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Duan, Naihua/0000-0001-9411-2924'
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pages: 655-676
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papis_id: 4a6b68280c834ce76ada4593f2aabbde
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ref: Cunningham2005effectsocioeconomic
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researcherid-numbers: 'Hays, Ron D./D-5629-2013
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'
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times-cited: '76'
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title: The effect of socioeconomic status on the survival of people receiving care
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for HIV infection in the United States
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000233779500008
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usage-count-last-180-days: '1'
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usage-count-since-2013: '6'
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volume: '16'
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web-of-science-categories: Health Policy \& Services; Public, Environmental \& Occupational
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Health
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year: '2005'
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