Special Article
The Care of HIV-Infected Adults in the United States
N Engl J Med 1998; 339:1897-1904December 24, 1998
- Abstract
Background and Methods
In order to elucidate the medical care of patients with human immunodeficiency virus (HIV) infection in the United States, we randomly sampled HIV-infected adults receiving medical care in the contiguous United States at a facility other than a military, prison, or emergency department facility during the first two months of 1996. We interviewed 76 percent of 4042 patients selected from among the patients receiving care from 145 providers in 28 metropolitan areas and 51 providers in 25 rural areas.
Results
During the first two months of 1996, an estimated 231,400 HIV-infected adults (95 percent confidence interval, 162,800 to 300,000) received care. Fifty-nine percent had the acquired immunodeficiency syndrome according to the case definition of the Centers for Disease Control and Prevention, and 91 percent had CD4+ cell counts of less than 500 per cubic millimeter. Eleven percent were 50 years of age or older, 23 percent were women, 33 percent were black, and 49 percent were men who had had sex with men. Forty-six percent had incomes of less than $10,000 per year, 68 percent had public health insurance or no insurance, and 30 percent received care at teaching institutions. The estimated annual direct expenditures for the care of the patients seen during the first two months of 1996 were $5.1 billion; the expenditures for the estimated 335,000 HIV-infected adults seen at least as often as every six months were $6.7 billion, which is about $20,000 per patient per year.
Conclusions
In this national survey we found that most HIV-infected adults who were receiving medical care had advanced disease. The patient population was disproportionately male, black, and poor. Many Americans with diagnosed or undiagnosed HIV infection are not receiving medical care at least as often as every six months. The total cost of medical care for HIV-infected Americans accounts for less than 1 percent of all direct personal health expenditures in the United States.
Media in This Article
Figure 1
Sources of Care Received by HIV-Infected Adults.Figure 2
Use of Protease Inhibitors and Non-Nucleoside Reverse-Transcriptase Inhibitors during 1996.Article Activity
- Article
Although much has been learned about the care of persons with human immunodeficiency virus (HIV) infection, there are persistent questions about the population under care, how much care they receive, where they get it, what it costs, and who pays for it. Unbiased answers to questions such as these are crucial to understanding the care of HIV-infected people, whether new research is being translated into practice, and where future clinical and policy challenges will lie. The generalizability of available studies has been limited by the use of patient groups selected because of location, convenience of sampling, or some other arbitrary reason.1-3 For example, the HIV Outpatient Study Investigators' report of clinical success with highly active antiretroviral regimens is valuable, but the experience in the elite clinics included in the study may be atypical of what happens in other settings.4
Data from representative national cohorts provide a context for the interpretation of studies of local or convenience cohorts. Only representative national data can directly address issues for the nation as a whole. For these reasons, the HIV Cost and Services Utilization Study used probability sampling to assemble a nationally representative cohort of HIV-infected persons receiving regular medical care and of their providers.5
Methods
Study Sample
We used multistage national probability sampling to select the study cohort.6 The reference population was made up of persons at least 18 years of age with known HIV infection who made at least one visit for regular care in the contiguous United States to a private, federal, or other government facility other than a military or prison hospital or emergency department between January 5 and February 29, 1996 — except for one city where sampling began and ended two months later.7,8 In the first stage of sampling, we randomly selected 28 metropolitan statistical areas and 24 clusters of rural counties that, in the aggregate, contained nearly 70 percent of all U.S. cases of the acquired immunodeficiency syndrome (AIDS).7,8 In the second stage, we randomly selected 58 institutional or individual providers known to care for patients with HIV infection (known HIV providers) in urban areas and 28 in rural areas, who had been identified by local physicians or public health officials, as well as 87 “other providers” in urban areas and 23 in rural areas, who had confirmed in a screening survey of approximately 4000 physicians that they cared for eligible patients with HIV. In the third stage, we randomly selected anonymous patients (identified by unique codes) from lists of all eligible patients seen at the outpatient or inpatient services of participating providers during January and February 1996.
In the first two stages, we set sampling rates proportionate to case load. In the third stage, we set sampling rates to equalize the probability of selection within subgroups while increasing the overall sampling rate for women and members of private staff-model health maintenance organizations. We removed duplicate codes from lists of patients so that each patient appeared only once on a list, regardless of the number of visits he or she made to the provider, and we used adjustment for multiplicity (discussed below) to compensate for the fact that some patients visited more than one provider.
After the replacement of a single urban provider with an equivalent one in the same community, we obtained agreement to participate from 100 percent of known providers in urban areas and 79 percent in rural areas, 70 percent of other providers in urban areas and 83 percent in rural areas, and 84 percent of the selected patients. We interviewed 76 percent of the 4042 patients selected, 2864 of whom provided full interviews. The coverage rate, or the ratio of the population directly represented to the population that would have been represented if all patients and providers had participated, was 68 percent for long-form interviews and 87 percent for the combination of long-form, short-form, and proxy interviews and forms completed by providers when no interview was possible (nonresponse forms).
For each respondent, we constructed an analytic weight to adjust the sample to represent the entire reference population. Each weight, which can be interpreted as the number of persons represented by that respondent, is the product of the sampling weight, which adjusts for differential sampling probabilities, a “multiplicity weight,” which adjusts for patients who could have entered the sample through their visits to multiple providers, and a “nonresponse weight,” which adjusts for differences in rates of cooperation.9 We also developed alternative weights to extrapolate from the study reference population of persons seen in the first two months of 1996 to the population receiving care, which we defined as those who would have been seen during a typical six-month period in that year. That is, we used these alternative weights to adjust for the exclusion from the reference population of some persons who were seen at intervals greater than two months.
Centrally trained personnel from the National Opinion Research Center used computer-assisted personal interviewing to conduct all interviews.10 Ninety-two percent of interviews were conducted in person, and the remainder were conducted over the telephone. Shortened or proxy interviews were attempted or nonresponse forms obtained whenever full interviews were unobtainable. We approached subjects for interviews only after their providers obtained their permission. The RAND institutional review board and, if available, a local board reviewed all forms and materials.
Statistical Analysis
We analyzed data from the base-line interview, which had a maximal recall period of six months, along with selected data from the first follow-up interview. Base-line interviews began in January 1996 and ended 15 months later. We incorporated the analytic weights mentioned above into all analyses. We adjusted all standard errors and statistical tests to compensate for the complex sample design and differential weighting by means of linearization methods available in the SUDAAN and Stata software packages.11 We used randomly drawn “donor” responses within strata of respondents (“hot deck” imputation) to fill in less than 5 percent of CD4+ lymphocyte counts for which data were missing, less than 3 percent of insurance and income values, and less than 0.5 percent of other essential missing values.12
We estimated the use of pharmaceuticals from patients' reports and estimates by experts of typical daily doses. We estimated costs on the basis of average prices for a monthly supply of the appropriate medication and dosage, including fees for dispensing or administration, from a national retail pharmacy, a university hospital participating in a buying consortium, and a federal distributor. Prices for services were estimated both on the basis of reimbursement data from the AIDS Cost and Service Utilization Study with adjustment for inflation according to the Medical Price Index and on the basis of current weighted average Medicare reimbursement rates for the cities in the study.3,13 This procedure resulted in the assignment of costs of $200, $338, and $1,606 to services associated with outpatient visits, emergency department visits, and hospital days, respectively.
Results
Population Size and Characteristics
We estimated that 231,400 (95 percent confidence interval, 162,800 to 300,000) adults with known HIV infection received medical care at eligible sites during the first two months of 1996 (Table 1Table 1
Characteristics of the 231,400 HIV-Infected Persons According to CD4+ Cell Count.). On the basis of the patients' reports, the lowest-ever CD4+ lymphocyte count was less than 50 cells per cubic millimeter for 54,600 patients (24 percent), 50 to 199 cells per cubic millimeter for 68,200 patients (29 percent), 200 to 499 cells per cubic millimeter for 86,700 patients (37 percent), and 500 cells per cubic millimeter or higher for 21,900 patients (10 percent). Clinical stage, sex, employment status, and type of insurance were most strikingly associated with the CD4+ lymphocyte count. Only 24,200 patients (10 percent) had asymptomatic disease (Centers for Disease Control and Prevention [CDC] stage A), whereas 118,400 (51 percent) had symptomatic disease (CDC stage B) and 88,800 (38 percent) reported a history of an AIDS-defining illness (CDC stage C). Overall, 135,500 (59 percent) met the CDC case definition for AIDS.Seventy-seven percent (179,200) of the patients were men, and 89 percent (205,000) were less than 50 years old. Approximately half (114,000) were non-Hispanic whites, one third were non-Hispanic blacks (75,800), and almost one sixth (34,200) were Hispanic. Most of the others were Asian, Pacific Islanders, or Native Americans (1 percent each). Forty-nine percent (112,400) of patients were men who had had sex with men but reported no injection-drug use, and 24 percent (55,800) reported injection-drug use, with or without other risk behaviors. The remainder included 18 percent (42,700) who reported only heterosexual sex and 9 percent (20,500) who reported no known risk factors. Forty-eight percent of the patients (110,200) had some college education, and 37 percent (86,300) were employed. Forty-six percent (105,300) had annual household incomes of less than $10,000 per year, and 72 percent (165,500) had household incomes of less than $25,000 per year. Thirty-two percent of the patients (73,700) had private health insurance, 29 percent (67,600) were covered only by Medicaid, 20 percent (45,700) had no insurance, and 19 percent (44,300) of patients were covered by Medicare, usually in conjunction with Medicaid.
The Midwest accounted for 11 percent of the patients (25,700), for a rate of about 42 patients per 100,000 population.14 The Northeast and the West accounted for 25 percent (57,100 patients) and 28 percent (65,700 patients), respectively, and similar rates of about 112 patients per 100,000. The South accounted for 36 percent of the patients (83,000), for a rate of about 90 per 100,000. Providers known to care for substantial numbers of patients with HIV (known providers) saw 70 percent of the patients (161,800); teaching institutions saw 42 percent of this group, or 30 percent of all patients (69,100) (Figure 1Figure 1
Sources of Care Received by HIV-Infected Adults.). Practices with case loads of at least 250 individual HIV-infected patients per month saw 18 percent (41,700) of the patients, those with case loads of 50 to 249 saw 60 percent (138,600), those with case loads of between 5 and 49 saw 19 percent (43,600), and those with fewer than 5 patients saw only 3 percent (7500) of the patients.Contrasts in the HIV-Infected Population
All the associations shown in Table 2Table 2
Characteristics of the 231,400 HIV-Infected Persons, According to Sex, Risk Category, Region, and Type of Insurance. except that between type of provider and sex or risk group were significant at P≤0.05. As compared with men, women were less likely to have had an AIDS-defining illness (29 percent vs. 41 percent) and more likely to be young (age <35 years old, 44 percent vs. 31 percent) and black (54 percent vs. 27 percent) (Table 2). Women were also less highly educated (high school or less, 73 percent, vs. 46 percent for men) and less likely to be employed (not employed, 76 percent vs. 59 percent). Consequently, they were more often impoverished (annual household income <$5,000 per year, 30 percent vs. 17 percent) and underinsured (no private insurance, 85 percent vs. 63 percent). As compared with the other risk groups, men who had had sex with men were more highly educated (some college, 65 percent vs. 27 to 39 percent), were more likely to be employed (50 percent vs. 21 to 30 percent), and had higher incomes (annual household income ≥$25,000, 43 percent vs. 13 to 18 percent). They were also more likely to have private insurance (47 percent vs. 15 to 25 percent) and to live in the West (43 percent vs. 10 to 20 percent). The West was the only region where a majority of the patients represented (51 percent) had private insurance, but it was also common in the Midwest (41 percent). Private insurance was uncommon in the Northeast (19 percent), where most of the patients without private insurance were covered by Medicaid, and in the South (23 percent), where most of those without private insurance were uninsured. As expected, reliance on public insurance was associated with advanced disease.Use and Direct Cost of Medical Care
The 231,400 patients in the reference population made 1.95 million outpatient visits, or 1.4 visits per person per month, in the six months before the base-line interview. One third of the population made at least 1 visit to an emergency department; there were a total of 154,000 visits over six months. Twenty percent of the population was hospitalized, using a total of 694,000 days of hospital care, or 10.4 days per hospitalized patient per six months. Eighty-five percent used at least one medication for HIV, and 79 percent used an antiretroviral drug during the six months before the interview. Sixty-one percent used antiretroviral drugs in combination, so that the population had a total of 61.6 million days of antiretroviral therapy in the six months before the interview. The pattern of use of protease inhibitors and non-nucleoside reverse-transcriptase inhibitors changed rapidly during 1996. According to estimates of the date of first use for the whole cohort, about 16 percent of the patients had used one of the newer drugs by January 31, 36 percent by July 31, and 55 percent by December 31, 1996 (Figure 2Figure 2
Use of Protease Inhibitors and Non-Nucleoside Reverse-Transcriptase Inhibitors during 1996.).We used average prices for services to estimate the direct cost of medical care, which excludes the cost of home or domiciliary care, durable equipment, and the like. For the reference population, the estimated annual expenditures were $5.1 billion, or $22,200 per patient per year. This includes $2.0 billion (40 percent of the total) for pharmaceuticals, $2.2 billion (43 percent) for hospital care, $0.1 billion (2 percent) for emergency department care, and $0.8 billion (15 percent) for other outpatient care and associated tests.
The Population under Care
The models generating alternative weights that we used to extrapolate from the reference population to the population receiving care during a typical six-month period in 1996 yielded population size estimates ranging from 292,000 to 372,000 and centering on 335,000. This suggests that extending the sampling period to six months would have resulted in a sample that directly represented about 60,000 to 140,000 additional persons.
We used analyses incorporating the alternative weights to correct for the underrepresentation of persons in the reference population who made visits at intervals of more than two months. The results of these analyses suggest that the population seen during the six-month period varies from the reference population seen over a two-month period by no more than 3 percent for all of the characteristics listed in Table 1 (data not shown). Moreover, a six-month population would have used about 2,080,000 outpatient visits, 214,500 emergency department visits, 963,500 hospital days, and 85.0 million patient-days of antiretroviral therapy per six months. Annual expenditures by this population would have been about $6.7 billion, or roughly $20,000 per patient per year.
Discussion
The quarter-million adults who received care for HIV in the United States during the first two months of 1996 were strikingly different from the general population. As compared with others in the nonelderly population, adult patients with HIV were about half as likely to be women, to be employed, to have a household income above the 25th percentile, or to have private insurance.14-16 Although adult patients with HIV were only about one fifth more likely to lack health insurance than the general population, they were three times as likely to be insured by Medicaid and nine times as likely to have Medicare coverage.16 This is true despite the fact that the educational level of patients with HIV and the general population appears to be similar, with just less than half of both groups reporting some college education.17
There were large variations in the characteristics of the patients according to race, sex, stage of disease, and region of the United States. For example, as compared to HIV-infected men, HIV-infected women were about twice as likely to be black, to have an annual household income of less than $5,000, or to lack private health insurance (Table 2). Overall, 68 percent of all patients relied on public programs or personal assets to finance their care, but patients in the Midwest and West were roughly twice as likely as others to have private insurance. Moreover, there were 2 uninsured patients for every 10 patients covered by Medicaid in the Northeast, but 11 for every 10 in the South. This variable and fragmented financing of care will be an increasingly important concern as survival improves and the prevalence of HIV infection increases in subgroups less likely to have private insurance.
Concern about patients' ability to pay for care does not imply that the total cost of care for HIV is inordinate. Data from both our study and the National Center for Health Statistics indicate that patients with HIV account for only about 1 percent of all hospital days in the United States.16 Similarly, the $6.7 billion in direct expenditures for care for HIV-infected adults seen every six months was less than 1 percent of the over $700 billion in U.S. expenditures for personal health care in 1996.16 This proportion is not excessive, considering that HIV infection, at its peak, accounted for about 7 percent of the total potential years of life lost in the United States, or more than pneumonia, influenza, chronic obstructive pulmonary disease, diabetes mellitus, and chronic liver disease combined.16,18 Therefore, the crisis in expenditures for patients with HIV disease appears to be one of financing, not cost.
The components of the expenditures for care for HIV-infected patients are also of interest. In 1996, hospital care was the most expensive component, but the costs of pharmaceuticals were already double the amount spent on all the components of outpatient care other than pharmaceuticals. We expect this proportion to increase and hospital expenditures to decline with the increasing use of highly effective combination antiretroviral therapy. Although the use of newer antiretroviral drugs across the country falls short of that achieved in the HIV Outpatient Study, the rapid increase in the use of these drugs during 1996 is impressive.4 This rapid diffusion of new treatments is consistent with our finding that the vast majority of patients are seen by providers who are experienced in caring for patients with HIV infection and who are likely to adopt new antiretroviral regimens early on.
The majority of patients receiving care for HIV infection had indications for antiretroviral therapy.18,19 That is, about 60 percent had AIDS according to the CDC case definition and for about 90 percent the lowest CD4+ lymphocyte count was below 500 cells per cubic millimeter. This contrasts with natural-history studies that estimate the respective proportions to be about one third and two thirds of all persons with known or unrecognized HIV infection.20,21 Moreover, the extrapolations from our reference population to the population of HIV-infected persons seen by providers during a six-month period suggest that over 85 percent of adults estimated to have AIDS, as defined by the CDC, saw a doctor at least every six months.22 This implies that the HIV-infected adults who are not receiving regular care are primarily those with early and quite possibly unrecognized HIV infection.
A comparison of the range of our point estimates of the number of adults seen every six months (292,000 to 372,000) with the range of CDC estimates of the number of persons with known or unknown HIV infection (650,000 to 900,000) gives a rough estimate of the adult population of HIV-infected persons not receiving care in the United States.23 In making this comparison, we first removed those not included in the reference population from the CDC estimates. That is, we subtracted about 0.5 percent for adolescents, about 4 percent for Americans living outside the contiguous United States, a similar percentage for those in the military or in prison, and the estimated 10,000 children with HIV infection.22,24-26 The resulting analysis suggested that 36 to 63 percent of all nonmilitary, nonincarcerated adults in the contiguous United States with known or unknown HIV infection see a provider outside of an emergency room at least every six months.
In summary, we used national probability sampling to characterize a specified population of HIV-infected persons receiving regular medical care in the United States. The results demonstrate that it is feasible to obtain comprehensive, nationally representative data on particular chronic illnesses. Our most important initial findings are that the characteristics of those receiving care vary widely but are generally very different from those of the general population, that major teaching hospitals care for 30 percent of patients, that many Americans with early and probably unrecognized HIV infection are not receiving regular care, and that the cost of care for HIV infection is not inordinate, considering the morbidity and mortality associated with the disease.
Supported by a cooperative agreement (U-01HS08578) between RAND and the Agency for Health Care Policy and Research and by the Health Resources and Services Administration, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institutes of Health Office of Research on Minority Health through the National Institute of Dental Research, the Robert Wood Johnson Foundation, Merck and Company, Glaxo Wellcome, Bristol-Myers Squibb, Quest Diagnostics, the National Institute on Aging, and the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services. Dr. Duan is a senior fellow in statistics at RAND. Dr. Bozzette is a Health Services Research and Development Senior Research Associate of the Department of Veterans Affairs.
We are indebted to the participating subjects and sites, the staff at RAND, the RAND Survey Research Group, the University of California at Los Angeles, the University of California at San Diego, and the National Opinion Research Center.
Source Information
From RAND Health, Santa Monica, Calif. (S.A.B., S.H.B., N.D., A.A.L., J.W.S., S.C.M., M.F.S.); the Veterans Affairs San Diego Healthcare System, San Diego, Calif., and the University of California at San Diego, La Jolla (S.A.B.); the University of California at Los Angeles (A.A.L., M.F.S.); the National Opinion Research Center, Chicago (M.R.F., C.-A.E.); Baruch College, City University of New York, New York (M.R.F.); Project Hope, Bethesda, Md. (M.L.B.); and the Agency for Health Care Policy and Research, Rockville, Md. (D.L.).
Address reprint requests to Dr. Bozzette or Dr. Shapiro, HCSUS Office, RAND, 1700 Main St., Santa Monica, CA 90407-2138.
The other members of the HIV Cost and Services Utilization Study Consortium are listed in the Appendix.
Other authors were Ronald M. Andersen, Ph.D., William E. Cunningham, M.D., M.P.H., Marvin Marcus, D.D.S., M.P.H., and Neil S. Wenger, M.D., University of California at Los Angeles; Leslie A. Athey, M.S., and Stephen M. Smith, M.A., National Opinion Research Center, Chicago; Eric G. Bing, M.D., Drew University, Los Angeles; Julie A. Brown, B.A., M. Audrey Burnham, Ph.D., Dana P. Goldman, Ph.D., David E. Kanouse, Ph.D., Joan W. Keesey, B.A., Daniel F. McCaffrey, Ph.D., Judith F. Perlman, M.A., and Mark A. Schuster, M.D., Ph.D., RAND Health, Santa Monica, Calif.; Paul D. Cleary, Ph.D., Harvard Medical School, Boston; John A. Fleishman, Ph.D., Agency for Health Care Policy and Research, Rockville, Md.; Ron D. Hays, Ph.D., RAND Health, Santa Monica, Calif., and the University of California at Los Angeles; J. Allan McCutchan, M.D., and Douglas Richman, M.D., University of California at San Diego, La Jolla.
Appendix
In addition to the authors, the members of the HIV Cost and Services Utilization Study Consortium were as follows: Sponsor Representatives — R. Arnett, L. Cohen, I. Garcia, S. Genser, F. Hellinger, D. Hsia, E. Kousvelari, W. Maas, K.M. Magruder, K. Malitz, K.M. Marconi, M. McKinney, S. Niemcryk, M. Ory, J. Polinicek, V. Smeriglio, B. Vitiello, and N. Weissman; Collaborators — B.L. Allen, K.M. Anastos, P. Arno, S. Asch, G. Bowie, R.L. Brandt, Jr., L.S. Brown, Jr., R. Bussing, A.D. Carter, M. Chesney, D. Cleri, D.L. Cohn, S.E. Cohn, A.C. Collier, R. Collins, I. Coulter, S. Crystal, J. Currier, P. DePoy, F. Demarest, A. Espinoza, C.J. Fichtenbaum, M.A. Fischl, N.M. Flynn, P. Francis, J. Freed, K.A. Freedberg, G. Fulop, T. Gerst, A.L. Gifford, C. Golin, C. Good, N. Halfon, M. Heck, R. Hiatt, L. Hill, P. Hoy, S.C. Hunt, B. Jaworski, L.G. Kaplowitz, G. Karam, M. Katz, M. Kitihata, B. Landon, J. Leon, D. Lieu, A.S. London, D. Longshore, R.R. MacGregor, C.A. Maida, T. Mark, C. Mathews, C. McLaughlin-Miley, E.N. Miller, S. Miller, V. Mor, F. Palella, Jr., G. Perez, P. Pierce, W.G. Powderly, S.M. Puentes, C.A. Reitmeifer, D.D. Richman, H.S. Sacks, R. Santos, C. Schur, M. Schuster, A. Scitovsky, G. Scott, J. Shaul, S. Sheehey, C.D. Sherbourne, M. Stein, S. Strong, S. Thompson, J. Toney, B. Turner, L. von Behren, I.B. Wilson, C. Winslow, A. Wu, S. Zierler, and P. Zinner; Community Advisory Board — J. Alford, D. Bryan, K. Cylar, M. Diaz, F. Eggan, R. Milet Hernandez, K. Kuromiya, M. Lucey, C. Nelson, R. Presley, and G. Haas (deceased); Scientific Advisory Committee — J.E. Osborn (chair), L. Aday, J. Bartlett, G. DeFriese, C. Eisdorfer, N. Jewell, L. Kish, J. Lave, H.S. Luft, W.G. Manning, D. Mechanic, J. Newhouse, J. Phair, M. Smith, and P.A. Volberding.
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Mitchell D. Wong, William E. Cunningham, Martin F. Shapiro, Ronald M. Andersen, Paul D. Cleary, Naihua Duan, Hong Hu Liu, Ira B. Wilson, Bruce E. Landon, Neil S. Wenger, . (2004) Disparities in HIV Treatment and Physician Attitudes About Delaying Protease Inhibitors for Nonadherent Patients. Journal of General Internal Medicine 19:4, 366-374
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Salim S Abdool Karim, Quarraisha Abdool Karim, Gerald Friedland, Umesh Lalloo, Wafaa M El Sadr. (2004) Implementing antiretroviral therapy in resource-constrained settings. AIDS 18:7, 975-979
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Stephanie L. Taylor, M. Audrey Burnam, Cathy Sherbourne, Ron Andersen, William E. Cunningham. (2004) The relationship between type of mental health provider and met and unmet mental health needs in a nationally representative sample of HIV-positive patients. The Journal of Behavioral Health Services & Research 31:2, 149-163
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Federico Pulido, Jose R Arribas, Jose M Mir??, Mar??a A Costa, Juan Gonz??lez, Rafael Rubio, Jose M Pe??a, Miguel Torralba, Montserrat Lonca, Alicia Lorenzo, Concepcion Cepeda, Juan J V??zquez, Jose M Gatell. (2004) Clinical, Virologic, and Immunologic Response to Efavirenz-or Protease Inhibitor???Based Highly Active Antiretroviral Therapy in a Cohort of Antiretroviral-Naive Patients With Advanced HIV Infection (EfaVIP 2 Study). JAIDS Journal of Acquired Immune Deficiency Syndromes 35:4, 343-350
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Steven R. Young, Richard Conviser, Katherine Marconi, Melanie K. Wieland. (2004) Trends and Responsiveness in National Resource Allocation for Needed HIV Services. Journal of Health & Social Policy 17:4, 1-14
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Jennie C. I. Tsao, Aram Dobalian, Charles Moreau, Kendra Dobalian. (2004) Stability of Anxiety and Depression in a National Sample of Adults With Human Immunodeficiency Virus. The Journal of Nervous and Mental Disease 192:2, 111-118
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Aram Dobalian, Jennie C. I. Tsao, R. Paul Duncan. (2004) Pain and the Use of Outpatient Services Among Persons With HIV. Medical Care 42:2, 129-138
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Joan S. Tucker, Maria Orlando, M. Audrey Burnam, Cathy D. Sherbourne, Fuan-Yue Kung, Allen L. Gifford. (2004) Psychosocial Mediators of Antiretroviral Nonadherence in HIV-Positive Adults With Substance Use and Mental Health Problems.. Health Psychology 23:4, 363-370
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Gordon G Liu, Jeff J Guo, Scott R Smith. (2004) Economic Costs to Business of the HIV/AIDS Epidemic. PharmacoEconomics 22:18, 1181-1194
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Gwen van Servellen, Felix Carpio, Monica Lopez, Lorraine Garcia-Teague, Gilberto Herrera, Flor Monterrosa, Roberto Gomez, Emilia Lombardi. (2003) Program to Enhance Health Literacy and Treatment Adherence in Low-Income HIV-Infected Latino Men and Women. AIDS Patient Care and STDs 17:11, 581-594
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William G. Powderly, Kenneth H. Mayer. (2003) Editorial Commentary: Centers for Disease Control and Prevention Revised Guidelines for Human Immunodeficiency Virus (HIV) Counseling, Testing, and Referral: Targeting HIV Specialists. Clinical Infectious Diseases 37:6, 813-819
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Marc L Berk, Claudia L Schur, Jennifer L Dunbar, Sam Bozzette, Martin Shapiro. (2003) Short report: Migration among persons living with HIV. Social Science & Medicine 57:6, 1091-1097
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Christopher E. Bell, Marc F. Botteman, Xin Gao, Joel L. Weissfeld, Maarten J. Postma, Chris L. Pashos, Darrell Triulzi, Ulf Staginnus. (2003) Cost-effectiveness of transfusion of platelet components prepared with pathogen inactivation treatment in the United States. Clinical Therapeutics 25:9, 2464-2486
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Susan E Cohn, Rebecca A Clark. (2003) Sexually transmitted diseases, HIV, and AIDS in women. Medical Clinics of North America 87:5, 971-995
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Kenneth H. Mayer, Joseph W. Hogan, Dawn Smith, Robert S. Klein, Paula Schuman, Joseph B. Margolick, Christina Korkontzelou, Homayoon Farzedegan, David Vlahov, Charles C.J. Carpenter. (2003) Clinical and Immunologic Progression in HIV-Infected US Women Before and After the Introduction of Highly Active Antiretroviral Therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes 33:5, 614-624
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Grace E. Macalino, Hyejin Ko, David D. Celentano, Joseph W. Hogan, Ellie E. Schoenbaum, Paula Schuman, Josiah D. Rich. (2003) Drug Use Patterns Over Time Among HIV-Seropositive and HIV-Seronegative Women: The HER Study Experience. JAIDS Journal of Acquired Immune Deficiency Syndromes 33:4, 500-505
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Anita Palepu, Nicholas J. Horton, Nicole Tibbetts, Kim Dukes, Seville Meli, Jeffrey H. Samet. (2003) Substance abuse treatment and emergency department utilization among a cohort of HIV-infected persons with alcohol problems. Journal of Substance Abuse Treatment 25:1, 37-42
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An-Fu Hsiao, Mitchell D. Wong, David E. Kanouse, Rebecca L. Collins, Honghu Liu, Ronald M. Andersen, Allen L. Gifford, Allen McCutchan, Samuel A. Bozzette, Martin F. Shapiro, Neil S. Wenger. (2003) Complementary and Alternative Medicine Use and Substitution for Conventional Therapy by HIV-Infected Patients. JAIDS Journal of Acquired Immune Deficiency Syndromes 33:2, 157-165
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Aram Dobalian, Ronald M. Andersen, Judith A. Stein, Ron D. Hays, William E. Cunningham, Marvin Marcus. (2003) The Impact of HIV on Oral Health and Subsequent Use of Dental Services. Journal of Public Health Dentistry 63:2, 78-85
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Stephen Crystal, Ayse Akincigil, Usha Sambamoorthi, Neil Wenger, John A. Fleishman, David S. Zingmond, Ron D. Hays, Samuel A. Bozzette, Martin F. Shapiro. (2003) The Diverse Older HIV-Positive Population. JAIDS Journal of Acquired Immune Deficiency Syndromes 33:Sup 2, S76-S83
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Kitty S. Chan, Maria Orlando, Geoffrey Joyce, Allen L. Gifford, M. Audrey Burnam, Joan S. Tucker, Cathy D. Sherbourne. (2003) Combination Antiretroviral Therapy and Improvements in Mental Health: Results From a Nationally Representative Sample of Persons Undergoing Care for HIV in the United States. JAIDS Journal of Acquired Immune Deficiency Syndromes 33:1, 104-111
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Tamara L. Box, Maren Olsen, Eugene Z. Oddone, Sheri A. Keitz. (2003) Healthcare Access and Utilization by Patients Infected with Human Immunodeficiency Virus: Does Gender Matter?. Journal of Women's Health 12:4, 391-397
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Bruce E. Landon, Ira B. Wilson, Susan E. Cohn, Carl J. Fichtenbaum, Mitchell D. Wong, Neil S. Wenger, Samuel A. Bozzette, Martin F. Shapiro, Paul D. Cleary. (2003) Physician Specialization and Antiretroviral Therapy for HIV. Adoption and Use in a National Probability Sample of Persons Infected With HIV. Journal of General Internal Medicine 18:4, 233-241
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Timothy R. Juday, Albert Wu, David D. Celentano, Kevin D. Rick, Mei‐Cheng Wang, David Vlahov. (2003) The role of Medicaid HMO enrollment in the longitudinal utilization of medical care services in a cohort of injecting drug users in Baltimore, Maryland. Substance Abuse 24:1, 27-41
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Paulette D Stanford, Dina A Monte, Felecia M Briggs, Patricia M Flynn, Mary Tanney, Jonas H Ellenberg, Kathy L Clingan, Audrey Smith Rogers. (2003) Recruitment and Retention of Adolescent Participants in HIV Research: Findings From the REACH (Reaching for Excellence in Adolescent Care and Health) Project. Journal of Adolescent Health 32:3, 192-203
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Bozzette, Samuel A., Ake, Christopher F., Tam, Henry K., Chang, Sophia W., Louis, Thomas A., . (2003) Cardiovascular and Cerebrovascular Events in Patients Treated for Human Immunodeficiency Virus Infection. New England Journal of Medicine 348:8, 702-710
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Kathryn A. Phillips, Ronald Bayer, James L. Chen. (2003) New Centers for Disease Control and Prevention's Guidelines on HIV Counseling and Testing for the General Population and Pregnant Women. JAIDS Journal of Acquired Immune Deficiency Syndromes 32:2, 182-191
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Mari M. Kitahata, Stephen E. Rompaey, Peter W. Dillingham, Thomas D. Koepsell, Richard A. Deyo, Wayne Dodge, Edward H. Wagner. (2003) Primary Care Delivery Is Associated With Greater Physician Experience and Improved Survival Among Persons with AIDS. Journal of General Internal Medicine 18:2, 95-103
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Valerie E. Stone. (2003) Quality Primary Care for HIV/AIDS. . How Much HIV/AIDS Experience is Enough?. Journal of General Internal Medicine 18:2, 157-158
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Ira B. Wilson, Lin Ding, Ron D. Hays, Martin F. Shapiro, Samuel A. Bozzette, Paul D. Cleary. (2002) HIV Patients’ Experiences With Inpatient and Outpatient Care. Medical Care 40:12, 1149-1160
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J. Walkup, J. Satriano, D. Barry, P. Sadler, F. Cournos. (2002) HIV Testing Policy and Serious Mental Illness. American Journal of Public Health 92:12, 1931-1940
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Little, Susan J., Holte, Sarah, Routy, Jean-Pierre, Daar, Eric S., Markowitz, Marty, Collier, Ann C., Koup, Richard A., Mellors, John W., Connick, Elizabeth, Conway, Brian, Kilby, Michael, Wang, Lei, Whitcomb, Jeannette M., Hellmann, Nicholas S., Richman, Douglas D., . (2002) Antiretroviral-Drug Resistance among Patients Recently Infected with HIV. New England Journal of Medicine 347:6, 385-394
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R. J. Buchanan. (2002) Medicaid Managed Care and Coverage of Prescription Medications. American Journal of Public Health 92:8, 1238-1243
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Maria Orlando, M. Audrey Burnam, Robin Beckman, Sally C. Morton, Andrew S. London, Eric G. Bing, John A. Fleishman. (2002) Re-estimating the prevalence of psychiatric disorders in a nationally representative sample of persons receiving care for HIV: results from the HIV cost and services utilization study. International Journal of Methods in Psychiatric Research 11:2, 75-82
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Gifford, Allen L., Cunningham, William E., Heslin, Kevin C.Andersen, Ron M., Nakazono, TerryLieu, Dale K., Shapiro, Martin F., Bozzette, Samuel A., . (2002) Participation in Research and Access to Experimental Treatments by HIV-Infected Patients. New England Journal of Medicine 346:18, 1373-1382
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(2002) Hospital and Outpatient Health Services Utilization Among HIV-Infected Patients in Care in 1999. JAIDS Journal of Acquired Immune Deficiency Syndromes21-26
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Mira Johri, A. David Paltiel, Sue J. Goldie, Kenneth A. Freedberg. (2002) State AIDS Drug Assistance Programs. Medical Care 40:5, 429-441
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(2002) Hospital and Outpatient Health Services Utilization Among HIV-Infected Patients in Care in 1999. JAIDS Journal of Acquired Immune Deficiency Syndromes 30:1, 21-26
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Susan E. Cohn, Erin Kammann, Paige Williams, Judith S. Currier, Margaret A. Chesney. (2002) Association of Adherence to Mycobacterium avium Complex Prophylaxis and Antiretroviral Therapy with Clinical Outcomes in Acquired Immunodeficiency Syndrome. Clinical Infectious Diseases 34:8, 1129-1136
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K. E. Sherman, S. D. Rouster, R. T. Chung, N. Rajicic. (2002) Hepatitis C Virus Prevalence among Patients Infected with Human Immunodeficiency Virus: A Cross-Sectional Analysis of the US Adult AIDS Clinical Trials Group. Clinical Infectious Diseases 34:6, 831-837
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Claudia L. Schur, Marc L. Berk, Jennifer R. Dunbar, Martin E. Shapiro, Susan E. Cohn, Samuel A. Bozzette. (2002) Where to Seek Care: An Examination of People in Rural Areas With HIV/ AIDS. The Journal of Rural Health 18:2, 337-347
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A. Gregory DiRienzo, Charles van der Horst, Dianne M. Finkelstein, Peter Frame, Samuel A. Bozzette, Karen T. Tashima. (2002) Efficacy of Trimethoprim–Sulfamethoxazole for the Prevention of Bacterial Infections in a Randomized Prophylaxis Trial of Patients with Advanced HIV Infection. AIDS Research and Human Retroviruses 18:2, 89-94
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Lytt I. Gardner, Scott D. Holmberg, Janet Moore, Julia H. Arnsten, Kenneth H. Mayer, Anne Rompalo, Paula Schuman, Dawn K. Smith. (2002) Use of Highly Active Antiretroviral Therapy in HIV-Infected Women: Impact of HIV Specialist Care. JAIDS Journal of Acquired Immune Deficiency Syndromes 29:1, 69-75
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Bruce E. Landon, Ira B. Wilson, Neil S. Wenger, Susan E. Cohn, Carl J. Fichtenbaum, Samuel A. Bozzette, Martin F. Shapiro, Paul D. Cleary. (2002) Specialty Training and Specialization Among Physicians Who Treat HIV/AIDS in the United States. Journal of General Internal Medicine 17:1, 12-22
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A.C Justice, W Holmes, A.L Gifford, L Rabeneck, R Zackin, G Sinclair, S Weissman, J Neidig, C Marcus, M Chesney, S.E Cohn, A.W Wu. (2001) Development and validation of a self-completed HIV symptom index. Journal of Clinical Epidemiology 54:12, S77-S90
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L Backus, L Mole, S Chang, L Deyton. (2001) The immunology case registry. Journal of Clinical Epidemiology 54:12, S12-S15
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Steven M. Asch, Allen L. Gifford, Samuel A. Bozzette, Barbara Turner, W. Chris Mathews, Kiyoshi Kuromiya, William Cunningham, Ron Andersen, Martin Shapiro, Afshin Rastegar, J. Allen McCutchan. (2001) Underuse of Primary Mycobacterium avium Complex and Pneumocystis carinii Prophylaxis in the United States. JAIDS Journal of Acquired Immune Deficiency Syndromes 28:4, 340-344
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Susan E. Cohn, Marc L. Berk, Sandra H. Berry, Naihua Duan, Martin R. Frankel, Jonathan D. Klein, Martha M. McKinney, Afshin Rastegar, Stephen Smith, Martin F. Shapiro, Samuel A. Bozzette. (2001) The Care of HIV-Infected Adults in Rural Areas of the United States. JAIDS Journal of Acquired Immune Deficiency Syndromes 28:4, 385-392
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Troy D. Moon, Sten H. Vermund, Tony C. Tong, Scott D. Holmberg. (2001) Opportunities to Improve Prevention and Services for HIV-Infected Women in Nonurban Alabama and Mississippi. JAIDS Journal of Acquired Immune Deficiency Syndromes 28:3, 279-281
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Jasper M Bos, Lolkje TW de Jong-van den Berg, Maarten J Postma. (2001) Pharmacoeconomic evaluation of intensified antiretroviral treatment strategies in HIV/AIDS. Expert Review of Pharmacoeconomics & Outcomes Research 1:1, 77-84
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Scott R. Smith, Duane M. Kirking. (2001) The Effect of Insurance Coverage Changes on Drug Utilization in HIV Disease. JAIDS Journal of Acquired Immune Deficiency Syndromes 28:2, 140-149
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Dana P Goldman, Jayanta Bhattacharya, Daniel F McCaffrey, Naihua Duan, Arleen A Leibowitz, Geoffrey F Joyce, Sally C Morton. (2001) Effect of Insurance on Mortality in an HIV-Positive Population in Care. Journal of the American Statistical Association 96:455, 883-894
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Sheri A. Keitz, Tamara L. Box, Rick K. Homan, John A. Bartlett, Eugene Z. Oddone. (2001) Primary Care for Patients Infected with Human Immunodeficiency Virus. A Randomized Controlled Trial. Journal of General Internal Medicine 16:9, 573-582
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Benjamin Kim, Thomas M. Lyons, Jorge P. Parada, Constance R. Uphold, Paul R. Yarnold, Jennie B. Hounshell, Alison M. Sipler, Matthew B. Goetz, Jack A. DeHovitz, Robert A. Weinstein, Rafael E. Campo, Charles L. Bennett. (2001) HIV-related Pneumocystis carinii Pneumonia in Older Patients Hospitalized in the Early HAART Era. Journal of General Internal Medicine 16:9, 583-589
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Donna C. Futterman, Ligia Peralta, Bret J. Rudy, Susan Wolfson, Sally Guttmacher, Audrey Smith Rogers. (2001) The ACCESS (adolescents connected to care, evaluation, and special services) project: social marketing to promote HIV testing to adolescents, methods and first year results from a six city campaign. Journal of Adolescent Health 29:3, 19-29
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David D. Celentano, Noya Galai, Ajay K. Sethi, Nina G. Shah, Steffanie A. Strathdee, David Vlahov, Joel E. Gallant. (2001) Time to initiating highly active antiretroviral therapy among HIV-infected injection drug users. AIDS 15:13, 1707-1715
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B. R. Schackman, S. J. Goldie, M. C. Weinstein, E. Losina, H. Zhang, K. A. Freedberg. (2001) Cost-Effectiveness of Earlier Initiation of Antiretroviral Therapy for Uninsured HIV-Infected Adults. American Journal of Public Health 91:9, 1456-1463
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J. G. Kahn, B. Haile, J. Kates, S. Chang. (2001) Health and Federal Budgetary Effects of Increasing Access to Antiretroviral Medications for HIV by Expanding Medicaid. American Journal of Public Health 91:9, 1464-1473
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Michael D. Stein, William E. Cunningham, Terry Nakazono, Barbara J. Turner, Ron M. Andersen, Samuel A. Bozzette, Martin F. Shapiro. (2001) Screening for Cervical Cancer in HIV-Infected Women Receiving Care in the United States. JAIDS Journal of Acquired Immune Deficiency Syndromes 27:5, 463-466
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Michael D. Stein, William E. Cunningham, Terry Nakazono, Barbara J. Turner, Ron M. Andersen, Samuel A. Bozzette, Martin F. Shapiro. (2001) Screening for Cervical Cancer in HIV-Infected Women Receiving Care in the United States. Journal of Acquired Immune Deficiency Syndromes 27:5, 463-466
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R. S. Janssen, D. R. Holtgrave, R. O. Valdiserri, M. Shepherd, H. D. Gayle, K. M. De Cock. (2001) The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals. American Journal of Public Health 91:7, 1019-1024
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D. S. Zingmond, N. S. Wenger, S. Crystal, G. F. Joyce, H. Liu, U. Sambamoorthi, L. A. Lillard, A. A. Leibowitz, M. F. Shapiro, S. A. Bozzette. (2001) Circumstances at HIV diagnosis and progression of disease in older HIV-infected Americans. American Journal of Public Health 91:7, 1117-1120
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Philip Keiser, Naiel Nassar, Mary Beth Kvanli, Dianna Turner, James W. Smith, Daniel Skiest. (2001) Long-Term Impact of Highly Active Antiretroviral Therapy on HIV-Related Health Care Costs. Journal of Acquired Immune Deficiency Syndromes 27:1, 14-19
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Philip Keiser, Naiel Nassar, Mary Beth Kvanli, Dianna Turner, James W. Smith, Daniel Skiest. (2001) Long-Term Impact of Highly Active Antiretroviral Therapy on HIV-Related Health Care Costs. JAIDS Journal of Acquired Immune Deficiency Syndromes 27:1, 14-19
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J Kates. (2001) Developing a performance management system for a Federal public health program: the Ryan White CARE ACT Titles I and II. Evaluation and Program Planning 24:2, 145-155
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R. Stall, L. Pollack, T. C. Mills, J. N. Martin, D. Osmond, J. Paul, D. Binson, T. J. Coates, J. A. Catania. (2001) Use of antiretroviral therapies among HIV-infected men who have sex with men: a household-based sample of 4 major American cities. American Journal of Public Health 91:5, 767-773
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Douglas D. Richman. (2001) HIV chemotherapy. Nature 410:6831, 995-1001
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Robert J. Buchanan, Bonnie J. Chakravorty, Scott R. Smith. (2001) Eligibility Policies for the State AIDS Drug Assistance Programs. Social Work in Health Care 32:3, 81-104
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Trudy A. Larson, Linda M. Mundy, Lisa A. Melchior, A. T. Panter, Vivian B. Brown, Paul Chase, David A. Cherin, Tracey Gallagher, Victor F. German, Eustache Jean-Louis, Jay Kaplan, Sandra S. McDonald, Karen L. Meredith, Peter Reis, Karen Richardson-Nassif, Catherine Rohweder, Geoffrey A. D. Smereck, Anne Stanton, Judith Steinberg, Katherine Marconi, G. J. Huba. (2001) Finding the Underserved: Directions for HIV Care in the Future. Home Health Care Services Quarterly 19:1-2, 7-27
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Bozzette, Samuel A., Joyce, Geoffrey, McCaffrey, Daniel F., Leibowitz, Arleen A., Morton, Sally C., Berry, Sandra H., Rastegar, Afshin, Timberlake, David, Shapiro, Martin F., Goldman, Dana P., . (2001) Expenditures for the Care of HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy. New England Journal of Medicine 344:11, 817-823
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Freedberg, Kenneth A., Losina, Elena, Weinstein, Milton C., Paltiel, A. David, Cohen, Calvin J., Seage, George R., Craven, Donald E., Zhang, Hong, Kimmel, April D., Goldie, Sue J., . (2001) The Cost Effectiveness of Combination Antiretroviral Therapy for HIV Disease. New England Journal of Medicine 344:11, 824-831
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John G. Bartlett, Richard D. Moore. (2001) HIV Managed Care in the Maryland Health Choice Program. Infectious Diseases in Clinical Practice 10:Supplement 1, S25-S28
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Kevin C. Heslin, William E. Cunningham, Marvin Marcus, Ian Coulter, James Freed, Claudia Der-Martirosian, Samuel A. Bozzette, Martin F. Shapiro, Sally C. Morton, Ronald M. Andersen. (2001) A Comparison of Unmet Needs for Dental and Medical Care Among Persons with HIV Infection Receiving Care in the United States. Journal of Public Health Dentistry 61:1, 14-21
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Eduard J. Beck, Alec H. Miners, Keith Tolley. (2001) The Cost of HIV Treatment and Care. PharmacoEconomics 19:1, 13-39
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Mary Jane Rotheram-Borus, Peter A. Newman, Mark A. Etzel. (2000) Effective Detection of HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes 25, S105-S114
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Mary Jane Rotheram-Borus, Peter A. Newman, Mark A. Etzel. (2000) Effective Detection of HIV. Journal of Acquired Immune Deficiency SyndromesS105-S114
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Stephen Crystal, John A. Fleishman, Ron D. Hays, Martin F. Shapiro, Samuel A. Bozzette. (2000) Physical and Role Functioning Among Persons With HIV. Medical Care 38:12, 1210-1223
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Laurie Andrews, Gerald Friedland. (2000) PROGRESS IN HIV THERAPEUTICS AND THE CHALLENGES OF ADHERENCE TO ANTIRETROVIRAL THERAPY. Infectious Disease Clinics of North America 14:4, 901-928
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Allen L. Gifford, Rebecca Collins, David Timberlake, Mark A. Schuster, Martin F. Shapiro, Samuel A. Bozzette, David E. Kanouse. (2000) Propensity of HIV Patients to Seek Urgent and Emergent Care. Journal of General Internal Medicine 15:12, 833-840
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Rita Murri, Antonella Cingolani, Prospero Limongelli, Elena Visconti, Giuseppe Maiuro. (2000) Reduction of Bronchoscopy Performances Should Be Included in the Advantages of Highly Active Antiretroviral Therapy (HAART). JAIDS Journal of Acquired Immune Deficiency Syndromes 25:3, 286-287
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Carine Chaix-Couturier, Christopher Holtzer, Kathryn A. Phillips, Isabelle Durand-Zaleski, John Stansell. (2000) HIV-1 Drug Resistance Genotyping. PharmacoEconomics 18:5, 425-433
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Rita Murri, Antonella Cingolani, Prospero Limongelli, Elena Visconti, Giuseppe Maiuro. (2000) Reduction of Bronchoscopy Performances Should Be Included in the Advantages of Highly Active Antiretroviral Therapy (HAART). Journal of Acquired Immune Deficiency Syndromes286-287
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William E. Cunningham, Leona E. Markson, Ronald M. Andersen, Stephen H. Crystal, John A. Fleishman, Carol Golin, Allen Gifford, Honghu H. Liu, Terry T. Nakazono, Sally Morton, Samuel A. Bozzette, Martin F. Shapiro, Neil S. Wenger. (2000) Prevalence and Predictors of Highly Active Antiretroviral Therapy Use in Patients With HIV Infection in the United States. Journal of Acquired Immune Deficiency Syndromes115-123
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William E. Cunningham, Leona E. Markson, Ronald M. Andersen, Stephen H. Crystal, John A. Fleishman, Carol Golin, Allen Gifford, Honghu H. Liu, Terry T. Nakazono, Sally Morton, Samuel A. Bozzette, Martin F. Shapiro, Neil S. Wenger. (2000) Prevalence and Predictors of Highly Active Antiretroviral Therapy Use in Patients With HIV Infection in the United States. JAIDS Journal of Acquired Immune Deficiency Syndromes 25:2, 115-123
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Jill Jacobsen Ashman, Katherine M. Marconi, Martha M. McKinney, Joseph F. O'Neill. (2000) Who Receives Ryan White CARE Act Services? A Demographic Comparison of CARE Act Clients and the General AIDS Population. AIDS Patient Care and STDs 14:10, 561-565
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C Lavalle. (2000) Reduction in Hospitalization Costs, Morbidity, Disability, and Mortality in Patients with AIDS Treated with Protease Inhibitors. Archives of Medical Research 31:5, 515-519
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Barbara J. Turner, Craig J. Newschaffer, Daozhi Zhang, Leon Cosler, Walter W. Hauck. (2000) Antiretroviral Use and Pharmacy-Based Measurement of Adherence in Postpartum HIV-Infected Women. Medical Care 38:9, 911-925
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Michael D. Stein, William E. Cunningham, Terry Nakazono, Steven Asch, Barbara J. Turner, Stephen Crystal, Ron M. Andersen, Sally Zierler, Samuel A. Bozzette, Martin F. Shapiro. (2000) Care of Vaginal Symptoms Among HIV-Infected Women. JAIDS Journal of Acquired Immune Deficiency Syndromes 25:1, 51-55
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Michael D. Stein, William E. Cunningham, Terry Nakazono, Steven Asch, Barbara J. Turner, Stephen Crystal, Ron M. Andersen, Sally Zierler, Samuel A. Bozzette, Martin F. Shapiro. (2000) Care of Vaginal Symptoms Among HIV-Infected Women. Journal of Acquired Immune Deficiency Syndromes51-55
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Carine Chaix, Catherine Grenier-Sennelier, P. Clevenbergh, J. Durant, J. M. Schapiro, Pierre Dellamonica, Isabelle Durand-Zaleski. (2000) Economic Evaluation of Drug Resistance Genotyping for the Adaptation of Treatment in HIV-Infected Patients in the VIRADAPT Study. JAIDS Journal of Acquired Immune Deficiency Syndromes 24:3, 227-231
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Vivian B. Brown, Geoffrey A.D. Smereck, Victor German, Chi Hughes, Lisa A. Melchior, G.J. Huba. (2000) Change in Perceived Barriers and Facilitators to Treatment among Women with HIV/AIDS as a Function of Psychosocial Service Utilization. AIDS Patient Care and STDs 14:7, 381-390
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Usha Sambamoorthi, Lynn A. Warner, Stephen Crystal, James Walkup. (2000) Drug abuse, methadone treatment, and health services use among injection drug users with AIDS. Drug and Alcohol Dependence 60:1, 77-89
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Carine Chaix, Catherine Grenier-Sennelier, P. Clevenbergh, J. Durant, J. M. Schapiro, Pierre Dellamonica, Isabelle Durand-Zaleski. (2000) Economic Evaluation of Drug Resistance Genotyping for the Adaptation of Treatment in HIV-Infected Patients in the VIRADAPT Study. Journal of Acquired Immune Deficiency Syndromes 24:3, 227-231
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Wm. Christopher Mathews, J. Allen McCutchan, Steven Asch, Barbara J. Turner, Allen L. Gifford, Kiyoshi Kuromiya, Julie Brown, Martin F. Shapiro, Samuel A. Bozzette. (2000) National Estimates of HIV-Related Symptom Prevalence From the HIV Cost and Services Utilization Study. Medical Care 38:7, 750-762
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J. Levi, J. Kates. (2000) HIV: challenging the health care delivery system. American Journal of Public Health 90:7, 1033-1036
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M. A. Schuster, D. E. Kanouse, S. C. Morton, S. A. Bozzette, A. Miu, G. B. Scott, M. F. Shapiro. (2000) HIV-infected parents and their children in the United States. American Journal of Public Health 90:7, 1074-1081
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M. D. Stein, S. Crystal, W. E. Cunningham, A. Ananthanarayanan, R. M. Andersen, B. J. Turner, S. Zierler, S. Morton, M. H. Katz, S. A. Bozzette, M. F. Shapiro, M. A. Schuster. (2000) Delays in seeking HIV care due to competing caregiver responsibilities. American Journal of Public Health 90:7, 1138-1140
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Samuel A. Bozzette, Barbara Phillips, Steven Asch, Allen L. Gifford, Leslie Lenert, Terri Menke, Eduardo Ortiz, Douglas Owens, Lawrence Deyton. (2000) Quality Enhancement Research Initiative for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. Medical Care 38, I-60-I-69
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Joseph F. O'Neill, Katherine Marconi, Ann Surapruik, Nancy Blum. (2000) Improving HIV/AIDS services through palliative care: An HRSA perspective. Journal of Urban Health 77:2, 244-254
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