Regional Differences Among HIV Patients in Care: California Medical Monitoring Project Sites, 2007-2008



Susan Scheer*, 1, Alison J Hughes1, Judith Tejero2, Mark A Damesyn3, Karen E Mark3, Tyler M Arguello3, Amy R Wohl2
1 San Francisco Department of Public Health, San Francisco, CA, USA
2 Los Angeles County Department of Public Health, Los Angeles, CA, USA
3 California Department of Public Health, Sacramento, CA, USA


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© Scheer et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the San Francisco Department of Public Health, HIV Epidemiology Section, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102, USA; Tel: 415-554-9076; Fax: 415-431-0353; E-mail: susan.scheer@sfdph.org


Abstract

Introduction:

The Medical Monitoring Project (MMP) is a national, multi-site population-based supplemental HIV/AIDS surveillance project of persons receiving HIV/AIDS care. We compared California MMP data by region. Demographic characteristics, medical care experiences, HIV treatment, clinical care outcomes, and need for support services are described.

Methods:

HIV-infected patients 18 years or older were randomly selected from medical care facilities. In person structured interviews from 2007 - 2008 were used to assess sociodemographic characteristics, self-reported clinical outcomes, and need for supportive services. Pearson chi-squared, Fisher’s exact and Kruskal-Wallis p-values were calculated to compare regional differences.

Results:

Between 2007 and 2008, 899 people were interviewed: 329 (37%) in San Francisco (SF), 333 (37%) in Los Angeles (LA) and 237 (26%) in other California counties. Significant regional sociodemographic differences were found. Care received and clinical outcomes for patients in MMP were positive and few regional differences were identified. HIV case management (36%), mental health counseling (35%), and dental services (29%) were the supportive services patients most frequently needed. Unmet needs for supportive services were low overall. Significant differences by region in needed and unmet need services were identified.

Discussion:

The majority of MMP respondents reported standard of care CD4 and viral load monitoring, high treatment use, undetectable HIV viral loads and CD4 counts indicative of good immune function and treatment efficacy. Information from MMP can be used by planning councils, policymakers, and HIV care providers to improve access to care and prevention. Identifying regional differences can facilitate sharing of best practices among health jurisdictions.

Keywords: : HIV care, medical monitoring project, HIV surveillance, California..