Service utilization, service barriers, and gender among HIV-positive consumers in primary care.

Title I of the Ryan White CARE Act provides emergency assistance to localities disproportionately affected by HIV and AIDS. In 1999, the Title I Chicago Area HIV Services Planning Council expressed concern regarding the lack of a client-level database. In response to the Planning Council, evaluators conducted a longitudinal interview study of HIV-positive individuals who were receiving primary care at Title I funded clinics within Chicago and the surrounding collar counties. Analysis of baseline data explored gender differences in transmission risk, service utilization, and service barriers among study respondents. Among the 161 respondents, men were more likely than women to use alcohol and other drugs during sexual activity. Men were also more likely to use HIV medication. Women, however, were more likely to have someone to coordinate their HIV care. Close to half (47.2%) of these primary case patients reported at least one unmet service need, most frequently dental care, housing support and transportation. These findings suggest a continued need for HIV-related community-based services as well as increased attention to the unique experiences of both men and women within the HIV service system.