Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant medicaid enrollees, 2005-2007

S. Zhang, C. Senteio, J. Felizzola and G. Rust

American Journal of Public Health, 2013, vol. 103, issue 12, e46-e53

Abstract: Objectives. We examined racial/ethnic differences in prenatal antiretroviral (ARV) treatment among 3259 HIV-infected pregnant Medicaid enrollees. Methods. We analyzed 2005-2007 Medicaid claims data from 14 southern states, comparing rates of not receiving ARVs and suboptimal versus optimal ARV therapy. Results. More than one third (37.3%) had zero claims for ARV drugs. Three quarters (73.4%) of 346 Hispanic women received no prenatal ARVs. After we adjusted for covariates, Hispanic women had 3.89 (95% confidence interval = 2.58, 5.87) times the risk of not receiving ARVs compared with Whites. Hispanic women often had only 1 or 2 months of Medicaid eligibility, perhaps associated with barriers for immigrants. Less than 3 months of eligibility was strongly associated with nontreatment (adjusted odds ratio = 29.0; 95% confidence interval = 13.4, 62.7). Conclusions. Optimal HIV treatment rates in pregnancyareapublichealthpriority, especially for preventing transmission to infants. Medicaid has the surveillance and drug coverage to ensure that all HIV-infected pregnant women are offered treatment. States that offer emergency Medicaid coverage for only delivery services to pregnant immigrants are missing an opportunity to screen, diagnose, and treat pregnant women with HIV, and to prevent HIV in children.

Keywords: anti human immunodeficiency virus agent; anti human immunodeficiency virus agent, adult; African American; article; Caucasian; confidence interval; ethnology; factual database; female; health care disparity; Hispanic; human; Human immunodeficiency virus infection; medicaid; pregnancy; retrospective study; risk; United States; young adult; ethnology; health care disparity; HIV Seropositivity; United States, Adult; African Americans; Anti-HIV Agents; Confidence Intervals; Databases, Factual; European Continental Ancestry Group; Female; Healthcare Disparities; Hispanic Americans; HIV Seropositivity; Humans; Medicaid; Odds Ratio; Pregnancy; Retrospective Studies; United States; Young Adult, Adult; African Americans; Anti-HIV Agents; Confidence Intervals; Databases, Factual; European Continental Ancestry Group; Female; Healthcare Disparities; Hispanic Americans; HIV Seropositivity; Humans; Medicaid; Odds Ratio; Pregnancy; Retrospective Studies; United States; Young Adult (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301328_3

DOI: 10.2105/AJPH.2013.301328

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