Perspectives on a continuum of care for persons with HIV illnesses.

Abstract

A. E. Benjamin, Ph.D. is Adjunct Associate Professor and Associate Director, Institute for Health and Aging, University of California, San Francisco. Since the first cases of acquired immune deficiency syndrome (AIDS) were reported in the United States in 1981, the attention of both federal policymakers and the general public has been directed foremost at issues involving biomedical research, epidemiology, education, and testing. Not surprisingly, understanding the transmission of this catastrophic disease and seeking ways to contain it have tended to dominate serious public discussion of AIDS. As the numbers of persons with diagnoses of AIDS and human immunodeficiency virus (HIV)-related illnesses other than AIDS have grown, however, policymakers have necessarily had to devote more attention to a range of service delivery issues related to the provision of appropriate and costeffective care to those affected by the virus. Research on service delivery issues has been concerned more with the costs of AIDS care than with patterns of service, but this is changing in two related ways. First, those doing (or reviewing) cost studies have shifted attention from costs alone to service utilization and its relation-