INNER-CITY HIV PATIENTS FAIL TO TAKE ADVANTAGE OF AVAILABLE THERAPIES

CHICAGO--Despite the increasing availability of combination drug therapy proven to be highly effective at controlling the HIV virus, most inner-city HIV patients who are sick enough to require hospitalization choose not to receive outpatient care, according to a study by Emory University infectious disease specialists. Results of the study were presented on Feb. 1 at the 6th Conference on Retroviruses and Opportunistic Infections in Chicago.

Carlos del Rio, M.D., and his Emory colleagues studied patients within the Grady Health System, which serves the inner-city population of metro Atlanta through a large hospital and satellite outpatient clinics. At the Ponce de Leon Center, a comprehensive Atlanta HIV/AIDS outpatient clinic staffed by Emory medical faculty, patients have access to a highly trained primary provider as well as on-site services including oral and mental health, case management and housing assistance. Protease inhibitors have been used at the Center since March, 1996.

The investigators conducted a retrospective study of all HIV-associated discharges from Grady Memorial Hospital from 1994 to 1997 as well as the number of patients placed on HAART therapy (highly active anti-retroviral therapy) at the outpatient AIDS clinic.

By December, 1997, more than 1,000 patients had been prescribed HAART therapy in the outpatient AIDS clinic. However, less than 15% of patients who were hospitalized for HIV or AIDS had been seen at the outpatient clinic in six months prior to hospitalization or had ever been prescribed HAART. Neither the rate of hospitalizations for AIDS nor the rate of major opportunistic infections associated with HIV changed significantly during the study period.

"This study demonstrates that most HIV patients in the inner city do not take advantage of the very effective therapies that are available to them," Dr. del Rio said. "Although HAART has caused a dramatic decrease in AIDS-associated mortality and hospitalizations, for inner-city populations in particular, additional resources need to be allocated to get these patients into outpatient care."