block grant program, 153–157

enhanced or expanded Medicaid, 148–153, 195, 213–214, 230, 231

expanded CARE Act programs, 144–145

goals, 16, 141–142

HAART modeling for evaluation of, 214–216

inputs for modeling, 217–225

Medicare expansion, 145–148, 195

projected enrollment, 224–225

projected utilization, 223–224

prospects, 174–175

range of, 15–16, 141, 142, 213

sensitivity analyses, 234–243

state participation, 142–144

See also HIV Comprehensive Care Program

American Public Health Association, 47

Antiretroviral drugs

access disparities, 129–130

alternative therapies, 46

for children, 90

costs, 20, 21, 204, 270

effectiveness, 42, 43–44

technical evolution, 42–43

See also Highly active antiretroviral therapy

Anxiety disorders

adherence to HIV treatment and, 91

prevalence, 251, 253

risk behavior and, 54–55, 255

Assessment

adherence prediction, 49

depression, 55

insurance status and time of diagnosis, 274

role of primary care, 98

Asymptomatic infection, 40–41

At-risk populations, 37

implications for health care delivery, 50

trends, 9, 10, 38, 50, 63

Automobile restraints, 187

Awareness of HIV status, 156, 181, 218, 226

AZT, 42–43, 269, 299

B

Bailey Boushay House, 333

Balanced Budget Act, 18, 197

Barriers to care

in CARE Act programs, 118–122, 300

conflicting goals among programs, 133–134

coordination among programs and, 127–129, 136, 268, 305–306, 328

cost of care, 132–133

in current system, 6, 14, 19, 27, 133–134, 280–283, 304–307

in Medicaid, 12, 17, 109–114, 132–133, 291–293

in Medicare, 117, 295–297

mental illness, 55–56, 131

in private insurance programs, 107–109, 301, 302–303

provider reimbursement, 19, 111, 325–326

sources of, 129

for substance abusers, 58–59, 313, 318–323, 325–327, 330–332

for women of color, 59

See also Access to care

Bipolar disorder, 251

Block grants

advantages, 154

disadvantages, 155–157

structure, 153–154

substance abuse treatment, 324

C

Cancer, 44

Candidiasis, 42

Capitation rates, 111, 114

CARE Act. See Ryan White CARE Act

Care coordination model of service, 170

Care-seeking behavior

cost of care and, 132

substance abuse and, 58, 94, 319

Case management, 127

benefits, 96, 130–131

CARE Act coverage, 298–299

Centers of Excellence model, 170

definition, 96

delivery models, 96

HAART utilization and, 224

modeling service needs, 223–224

CD4 lymphocyte levels

course of HIV, 41, 42

depression effects, 93–94

HAART guidelines, 44, 89



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