NC State Research Indicates Need For National HIV Strategy

The U.S. Centers for Disease Control and Prevention estimate that well over one million people in the United States are infected with HIV/AIDS. New research from North Carolina State University shows that many of those infected are minorities and do not have health insurance, and highlights the need for a national strategy to facilitate education and prevention efforts in minority and low-income populations.

The research, which analyzed 90,000 HIV patient hospital visits over the course of one year, found that few of the patients had health care through their employers, and that the majority of the patients were black. “The study highlights the lack of a federal strategic plan supported by appropriate policy to address the high number of uninsured and minority groups dealing with HIV,” says Dr. Fay Cobb Payton, associate professor of information systems at NC State and author of the paper. “The numbers show that we need a national strategy for how to address these problems.”

Specifically, the study showed that only 17 percent of patients had health care through their employer, while 18 percent of patients were on Medicare and 64 percent were on Medicaid. The study also found that a staggering 75 percent of the HIV patients were black.

“Much of the health care system is based on one’s ability to navigate treatment, service delivery, payment guidelines and policies – all of which require some degree of adequate financial and educational resources,” Payton says. “A lot of times, these HIV patients come from a socioeconomic background that makes it unlikely they will have those resources.”

“For example,” Payton says, “a strategic plan is needed to address the levels of HIV we are seeing in the black community in the U.S. – particularly given the alarming rates in cities with large black populations, such as Washington, D.C., and the growing number of cases in the rural South.

“There’s a lot of education out there, but we need to engage the community better. Any strategic plan would need to include policies on disseminating HIV education, testing and overcoming social and cultural stigmas associated with the disease.” Payton co-authored a paper earlier this year in the European Journal of Information Systems highlighting the need to tailor Web sites and other communication tools to specific audiences, such as the black community, in order to make these tools more effective at providing those communities with information on HIV.

“For years the focus has been primarily on finding a cure for HIV/AIDS,” Payton says, “but what do we do in the meantime? We need a strategic plan, and we need grassroots approaches to prevention and education.”

The paper, “Beyond the IT Magic Bullet: HIV Prevention Education and Public Policy,” is published in the November issue of the Journal of Health Disparities Research and Practice.

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Note to Editors: The research abstract follows.

“Beyond the IT Magic Bullet: HIV Prevention Education and Public Policy”

Author: Fay Cobb Payton, North Carolina State University

Published: November, 2009, Journal of Health Disparities Research and Practice.

Abstract: Analytic applications are vital in the assessments of public health and surveillance as these applications can drive resource allocation, community assessment and public policy. Using a dataset of nearly 90,000 patient hospital encounters, the number of instances with an ICD code of HIV and co-morbidities was identified. Blacks accounted for 75 percent of HIV hospital encounters in the dataset. While business analytic applications informed this study of cross-tabulations and interaction effects among race, age and gender, there appears to be a significant relationship among HIV diagnoses and substance abuse. Payer data is informed by the Healthcare Cost and Utilization Project (HCUP), and these findings indicate significant service utilization among those insured by Medicare. More importantly, these issues raise more salient implications among the current health and public policy among HIV care delivery, in general, and among the Black community, in particular. Attention to health and public policy warrants further investigation given that this discourse has shifted to a focus on curvative medicine and away from prevention and education.