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a Project
HOPE Center for Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda,
MD 20814, USA
b
RAND, 1700 Main Street, Santa Monica, CA 90407, USA
Available online 28 January 2003.
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Data
from the first national probability sample of persons with HIV, the HIV
Cost of Services and Utilization Survey (HCSUS), are used to examine migration
patterns among persons with HIV/AIDS in the USA. Persons with serious illness
may choose to relocate to receive better care or support. This migration
has implications for the distribution of resources. This study describes
the frequency and reasons that persons with HIV move to different communities.
An analytic file of 3014 respondents was obtained from the first national
probability sample of persons with HIV/AIDS, the HCSUS. A migration section
of the baseline questionnaire questioned respondents on their residential
history. Persons were defined as movers if they moved across state lines
or to a non-contiguous county after knowing they were HIV positive but
before the HCSUS baseline interview. Forty percent of movers said that
their HIV status was a very important factor in their decision to move.
Although earlier studies of limited generalizability found movement among
the HIV population from urban to rural counties, this study found only
eight percent of HIV migration was from urban to rural counties, just slightly
more than the migration from rural to urban counties. In addition, the
vast majority of people who were moving were not moving to return home.
Major factors in the decision to move included being near caregivers and
being in a community with shared needs and interests. Significant numbers
of persons also moved to obtain care from a physician knowledgeable in
HIV treatment or to get away from discrimination. Financial assistance
and the availability of Medicaid also played a prominent role in many decisions
to move. Persons with HIV/AIDS are more likely to move than non-infected
persons in the general population. Moreover, they are almost twice as likely
to be moving out-of-state. Persons with HIV who move are similar to persons
with HIV who do not move on most demographic characteristics including
age, region of the country, and income.
Author Keywords: HIV; AIDS; Migration; Access; USA |
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