abstract: 'HIV-infected people with low socioeconomic status (SES) and people who

  are members of a racial or ethnic minority have been found to receive

  fewer services, including treatment with Highly Active Antiretroviral

  Therapy (HAART), than others. We examined whether these groups also have

  worse survival than others and the degree to which service use and

  antiretroviral medications explain these disparities in a prospective

  cohort study of a national probability sample of 2,864 adults receiving

  HIV care. The independent variables were wealth (net accumulated

  financial assets), annual income, educational attainment, employment

  status (currently working or not working), race/ethnicity, insurance

  status, use of services, and use of medications at baseline. The main

  outcome variable was death between January 1996 and December 2000. The

  analysis was descriptive and multivariate adjusted Cox proportional

  hazards regression analysis of survival.

  By December 2000, 20\% (13\% from HIV, 7\% non-HIV causes) of the sample

  had died. Those with no accumulated financial assets had an 89\% greater

  risk of death (RR= 1.89, 95\% CI= 1.15-3.13) and those with less than a

  high school education had a 53\% greater risk of death (RR= 1.53, 95\%

  CI= 1.15-2.04) than their counterparts, after adjusting for

  sociodemographic and clinical variables only. Further adjusting for use

  of services and antiretroviral treatment diminished, but did not

  eliminate, the elevated relative risk of death for those with low SES by

  three of the four measures. The finding of markedly elevated relative

  risks of death for those with HIV infection and low SES is of particular

  concern given the disproportionate rates of HIV infection in these

  groups. Effective interventions are needed to improve outcomes for low

  SES groups with HIV infection.'
affiliation: 'Cunningham, WE (Corresponding Author), Univ Calif Los Angeles, Sch Publ
  Hlth, Ctr Hlth Sci, 10833 Le Conte Ave,Rm 31-254A, Los Angeles, CA 90095 USA.

  Univ Calif Los Angeles, Div Gen Internal Med \& Hlth Serv Res, Dept Med, Los Angeles,
  CA 90024 USA.

  Univ Calif Los Angeles, Dept Hlth Serv, Sch Publ Hlth, Los Angeles, CA 90024 USA.

  RAND Corp, Hlth Sci Program, Santa Monica, CA 90406 USA.

  RAND Corp, Dept Psychiat \& Biobehav Sci, Santa Monica, CA 90406 USA.'
author: Cunningham, WE and Hays, RD and Duan, NH and Andersen, RM and Nakazono, TT
  and Bozzette, SA and Shapiro, MF
author-email: wcunningham@mednet.ucla.edu
author_list:
- family: Cunningham
  given: WE
- family: Hays
  given: RD
- family: Duan
  given: NH
- family: Andersen
  given: RM
- family: Nakazono
  given: TT
- family: Bozzette
  given: SA
- family: Shapiro
  given: MF
da: '2023-09-28'
eissn: 1548-6869
files: []
issn: 1049-2089
journal: JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED
keywords: HIV; AIDS; socioeconomic status; health services; outcomes; survival
keywords-plus: 'ACTIVE ANTIRETROVIRAL THERAPY; AIDS; ACCESS; ADULTS; HEALTH; MORTALITY;

  PREVALENCE; PREDICTORS; DISEASE; DEATH'
language: English
month: NOV
number: '4'
number-of-cited-references: '40'
orcid-numbers: 'Hays, Ron D./0000-0001-6697-907X

  Duan, Naihua/0000-0001-9411-2924'
pages: 655-676
papis_id: 4a6b68280c834ce76ada4593f2aabbde
ref: Cunningham2005effectsocioeconomic
researcherid-numbers: 'Hays, Ron D./D-5629-2013

  '
times-cited: '76'
title: The effect of socioeconomic status on the survival of people receiving care
  for HIV infection in the United States
type: Article
unique-id: WOS:000233779500008
usage-count-last-180-days: '1'
usage-count-since-2013: '6'
volume: '16'
web-of-science-categories: Health Policy \& Services; Public, Environmental \& Occupational
  Health
year: '2005'