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Changes in insurance status and access to care for persons with AIDS in the Boston Health Study.

J S Weissman, H J Makadon, G R Seage, 3rd, M P Massagli, C A Gatsonis, D E Craven, V E Stone, I A Bennett and A M Epstein

Department of Medicine, Brigham and Women's Hospital, Boston, MA.

The purpose of this study was to measure unmet needs and changes in insurance status for persons with acquired immunodeficiency syndrome (AIDS). Thirty-six percent of the study's Boston-area respondents (n = 305) had a change in insurance coverage between AIDS diagnosis and interview. Medicaid coverage increased from 14% to 41%. Pneumocystis carinii pneumonia prophylaxis was nearly universal. Only 5% did not receive zidovudine, and intravenous drug users were at higher risk. Approximately 14% to 15% of patients reported problems in obtaining medical and dental services; Blacks, homeless persons, and those who were not high school graduates were at higher risk. Use of selected treatments for which there were clear clinical guidelines was adequate, yet disadvantaged groups were more likely than other persons with AIDS to face obstacles to other services.

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