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The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act provides funds for comprehensive care for vulnerable individuals with HIV infection in all 50 States. As intended by the CARE Act, CARE clinics provide more specialized HIV care and multiple support services for vulnerable populations than other HIV clinics. CARE Act sites have more infectious disease specialists than other HIV clinics (3.1 vs. 1.7), more HIV-infected patients (an average of 1,048 vs. 512 at other clinics), and they provide more support services.
In a recent study that was supported in part by AHRQ (HS10408, HS10227, and HS08578), researchers analyzed data from the HIV Cost and Services Utilization Study (HCSUS), a nationally representative sample of HIV patients, to examine whether CARE Act clinics differed from other HIV clinics in the characteristics of their patients and their organization, staffing, and services. Data revealed that patients of CARE clinics were more likely to be female, younger, minority, and less educated than patients at other HIV clinics. They also were more likely to be unemployed, uninsured, low-income, and to report heterosexual contact as an HIV risk factor.
Overall, 77 percent of the CARE Act clinics specialized in HIV care compared with 37 percent of other clinics. The majority of CARE clinics provided a comprehensive approach to care. CARE clinics were more likely than other HIV clinics to have on-site nutritionists, mental health professionals, substance abuse counselors, and social workers; to hold multi-disciplinary team meetings to discuss care of HIV patients; and to offer non-clinical support services, such as housing, counseling, and translators. On average, 71 percent of HIV patients at CARE Act sites had case managers compared with 52 percent of those at other sites.
See "Differences in patient and clinic characteristics at CARE Act funded versus non-CARE Act funded HIV clinics," by Keith McInnes, M.S., Bruce E. Landon, M.D., M.B.A., Faye E. Malitz, M.S., and others, in the October 2004 AIDS Care 16(7), pp. 851-857.
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