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Socioeconomic disparities in access to HIV treatment programmes in resource-limited settings

Date: Poster sessions
Source: Forum 11
Authors: Alexander Tsai, House Officer, Langley Porter Psychiatric Institute, University of California, USA
with Mickey Chopra, Paul M Pronyk and Neil A Martinson


The objective of this study was to determine whether there were socioeconomic differences in the profile of HIV-positive people living in the community and HIV- positive patients presenting for hospital-based outpatient HIV care and related services.

A cross-sectional study was conducted in Limpopo province, South Africa among 776 HIV-positive people aged 18­35 years, including 534 consecutive patients who presented for care at a hospital-based outpatient HIV clinic, and 242 people living in the community.

People presenting at the clinic had a higher overall socioeconomic profile compared to the community sample. They were more likely to have completed secondary education (P<0.001), less likely to be unemployed (P<0.001), and more likely to live in households with access to a private tap water supply (P<0.001). These differences persisted after multivariable adjustment.

Important socioeconomic differences in uptake of hospital-based HIV care were identified among HIV-positive adults living in a rural region of South Africa. This suggests an important limitation in hospital-based HIV care and underscores the need to monitor the equity implications of antiretroviral treatment scale-up in resource- limited settings.