2014

Even with insurance, disparities remain in HIV/AIDS care among racial/ethnic minorities and seniors


Dr. Chandra Ford, professor of community health sciences, will lead a study examining factors preventing diagnosis and care.

People who are HIV-positive but begin care immediately can live long and stable lives; however, many do not. Among HIV-positive persons, blacks, Latinos and people 50 and older have disproportionately high rates of HIV/AIDS, and also die at disproportionately high rates. These disparities may even exist among people who have health insurance, which is perplexing to health professionals.

Now researchers from the UCLA Fielding School of Public Health and Kaiser Permanente Southern California have been awarded a $1.5 million grant from the National Institute of Nursing Research to understand this conundrum. Led by Chandra Ford, an assistant professor in the Department of Community Health Sciences at the Fielding School, the study will compare diverse managed care enrollees based on their assigned health care providers and the neighborhood conditions in which they live. 

“We want to know if there is something about the neighborhoods where people live, and the settings where they receive healthcare; for example, settings that mostly serve poor versus non-poor patients,” said Ford. “We also want to examine the kinds of providers they see, perhaps a provider of the same or different race or ethnicity. That may shape patients’ experiences receiving HIV/AIDS services. Further, are there some patients who face unique challenges because of these factors?”

The four-year study will also identify neighborhood conditions and provider factors that may make it hard for HIV-positive people to maintain their health. “This study expands on our prior work by focusing on insured patients and determining if--despite having insurance--blacks, Latinos and older adults face greater challenges to HIV/AIDS care than other patients do.”

The researchers will examine the electronic medical records (EMRs) of adults who receive their health care from Kaiser Permanente Southern California. They will analyze data from the last five years (2008-2012) of patients who were tested for HIV while receiving their primary care, to see if these patients faced any challenges receiving their diagnosis, treatment and care over the long term. The researchers will next link the EMRs to public data obtained from the Centers for Disease Control and Prevention and to socioeconomic indicators from the U.S. Census.

“By examining care patterns in this fully insured population, we may generate new insights into disparities,” said Ford. “Ultimately, we hope the findings will help insurers, providers and policymakers develop strategies to improve access to and equity in care across the lifespan for diverse individuals and communities.”

The interdisciplinary collaboration will leverage the expertise of a diverse team of new and seasoned investigators including William Cunningham, Lois Takahashi, Adey Nyamathi, and Chi-hong Tseng, UCLA; and Rulin Hechter from Kaiser Permanente Southern California.

Faculty Referenced by this Article

Dr. Chandra Ford
Chandra Ford
Community Health Sciences
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Dr. Randall Kuhn
Randall Kuhn
Community Health Sciences
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Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
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Courtney Thomas Tobin headshot.png
Courtney S. Thomas Tobin
Community Health Sciences
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Paula Tavrow
Paula Tavrow
Community Health Sciences
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Marjorie Kagawa-Singer
Marjorie Kagawa-Singer
Community Health Sciences
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Dr. Michael Prelip
Michael Prelip
Community Health Sciences
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Dr. Gilbert Gee
Gilbert C. Gee
Community Health Sciences
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Dawn Upchurch
Community Health Sciences
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Dr. Anne Pebley
Anne Pebley
Community Health Sciences
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Philip Massey headshot
Philip Massey
Community Health Sciences
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Natalie Muth
Community Health Sciences
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Dr. May Sudhinaraset
May Sudhinaraset
Community Health Sciences
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James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
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Dr. Donald Morisky
Donald E. Morisky
Community Health Sciences
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Cathy Lang
Cathy Lang

Assistant Dean for Research & Adjunct Associate Professor of Community Health Sciences

Community Health Sciences
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Sean Darling-Hammond
Sean Darling-Hammond
Biostatistics Community Health Sciences
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Wendelin Slusser
Community Health Sciences
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Kimberley Shoaf
Community Health Sciences
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Ondine S. von Ehrenstein
Community Health Sciences Epidemiology
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halbert, ronald
Ronald Halbert
Community Health Sciences
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Charlotte Neumann
Charlotte G. Neumann
Community Health Sciences
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Dr. Michael Rodriguez
Michael Rodriguez
Community Health Sciences
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Ilan H. Meyer
Ilan H. Meyer
Community Health Sciences
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Sheba George
Community Health Sciences
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Bo-Kyung Elizabeth Kim headshot.png
Bo-Kyung Elizabeth Kim
Community Health Sciences
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Robert Kim-Farley
Robert J. Kim-Farley

Robert J. Kim-Farley, MD, MPH, is a Professor-in-Residence with joint appointments in the Departments of Epidemiology and Community Health Sciences

Community Health Sciences Epidemiology
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Virginia C. Li
Virginia C. Li
Community Health Sciences
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Dr. Michael Goldstein
Michael Goldstein
Community Health Sciences
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Jennifer A. Wagman
Jennifer A. Wagman
Community Health Sciences
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glik, deborah
Deborah Glik
Community Health Sciences
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Dr. Alina Dorian
Alina Dorian
Community Health Sciences
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Dr. Elizabeth Yzquierdo
Elizabeth Yzquierdo
Community Health Sciences
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Kimberly Gregory
Kimberly Gregory
Community Health Sciences
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Dr. Dana Rose Garfin
Dana Rose Garfin
Community Health Sciences
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David Eisenman
David Eisenman
Community Health Sciences
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Dr. Jessica Gipson
Jessica Gipson
Community Health Sciences
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Dr. Hiram Beltrán-Sánchez
Hiram Beltrán-Sánchez
Community Health Sciences
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May Wang headshot
May C. Wang
Community Health Sciences
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Dr. Elizabeth D'Amico
Elizabeth D’Amico
Community Health Sciences
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Sarah Blenner
Sarah Blenner

Director of Field Studies and Applied Professional Training

Community Health Sciences
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Dana Hunnes
Dana Hunnes
Community Health Sciences
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Dena Herman
Dena Herman
Community Health Sciences
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Dr. Judith M. Siegel
Judith M. Siegel
Community Health Sciences
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Dr. Samuel Stratton
Samuel Stratton
Community Health Sciences
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