AIDS MEDICATIONS: One-Third of Patients Skip Treatment
One-third of the country's HIV-positive residents have gone without or postponed medical care at least once in the past six months due to time or money constraints, according to a study released today by researchers at the University of California-Los Angeles, the Rand Corp. and eight other institutions. Researchers conducted interviews with 2,864 HIV-positive adults in 1996-1997, and from that data estimated that nearly one-third of HIV patients nationwide, or 83,000 people, went without or postponed their treatment. According to the study, minorities, women, drug addicts and the poor were most likely to forego treatments in order to obtain other necessities. The study also found that 8% of those interviewed went without food or clothing in order to obtain medical care. Believed to be the first study to look at the "competing demands" facing those afflicted with chronic diseases, lead author Dr. William Cunningham, assistant professor at the UCLA schools of public health and medicine, said that most people choose to go without medication for economic reasons. Many said that they could not afford care, the transportation to receive care or the time off from work to undergo treatment. Cunningham added that the study provides policymakers with the message that "for complex diseases such as HIV, addressing social benefits and medical benefits at the same time may have the most benefit for the patients." Further complicating the issue, Cunningham noted that the results may underestimate the extent of the problem, as researchers interviewed only those patients who had obtained medical care in the past. Many HIV-infected people do not receive any medical care at all, he said.
Although they agree that economic constraints heavily influence patients' access to care, some AIDS activists point out that other factors play significant roles. Michael Weinstein, director of the AIDS Health Care Foundation in Los Angeles, said, "Patients very often say they don't really want care unless they're acutely ill." The complexity of the drug regimens provides a significant hurdle, especially for those who abuse drugs or who are mentally ill, said Susan Haikalis of the San Francisco AIDS Foundation. The Los Angeles Times reports that for many veteran workers in the field of HIV/AIDS, the study results came as little surprise. Vanessa Baird, acting chief of the California Office of AIDS, said that the problem has existed for many years and is of particular concern now, as the epidemic has shifted toward poor and minority communities. "I don't know that it's a problem that can ever be solved completely," Baird concluded (Landsberg, Los Angeles Times, 12/13).