Determinants of Longer Time from HIV Result to Enrollment in Publicly Funded Care and Treatment in California by Race/Ethnicity and Behavioral Risk

Abstract

The Early Intervention Program (EIP) is California's publicly funded human immunodeficiency virus (HIV) care and treatment program with 30 sites throughout the state. Our objective for this study was to examine the number of days from first HIV-positive result until enrollment into EIP by race/ethnicity, behavioral risk, and other characteristics, with data from clients who enrolled in an EIP site after the availability of highly active antiretroviral therapies. For Model I, logistic regression distinguished clients diagnosed with HIV and enrolled in EIP on the same day (0 days) from those with values of 1+ days; linear regression was then used on the log transformation of days for the majority of clients not diagnosed and enrolled on the same day. For Model II, logistic regression was used to identify client characteristics related to enrollment in EIP over 6 weeks from the date of HIV diagnosis. We found that Latinos were more likely than whites to enroll in EIP on the day they were diagnosed with HIV. For clients not diagnosed and enrolled in EIP on the same day, no differences across racial and ethnic groups were found for days until enrollment in HIV care and treatment. However, clients with a history of injection drug use took longer from the day they were diagnosed with HIV to enroll in EIP. The California EIP represents a model for programs seeking equity in access to HIV care and treatment across racial and ethnic groups. Getting injectors into timely HIV care and treatment represents a challenge.