Access to health care and geographic mobility of HIV/AIDS patients.

OBJECTIVE To determine the patterns and determinants of mobility in persons with HIV infection or AIDS on a population basis. DESIGN Descriptive cross-sectional population health study. TARGET POPULATION 650 full members (i.e., HIV-positive) of the Vancouver Persons with AIDS Society who were residents of British Columbia and who allow the society to include unsolicited material with their monthly newsletter. MAIN OUTCOME MEASURES Migration history, access to HIV-related care at diagnosis, current and pre-HIV sociodemographic characteristics, and current health status. RESULTS Two hundred and fifty-two persons living with HIV/AIDS participated in the study. At the time of the survey, the majority of subjects were male (94 percent), aged between 30 and 54 years (87 percent), and able to carry out daily activities without assistance (84 percent). The median time since the known date of HIV infection was 6 years. Access to care at diagnosis was associated in this population with being diagnosed in the largest metropolitan area in the province (OR = 2.14; 95 percent CI: 1.18, 3.87), a pre-HIV income of $30,000 or more per annum (OR = 0.49; 95 percent CI: 0.27, 0.89), a known date of diagnosis prior to 1990 (78 percent versus 64 percent; p = 0.019), and living in the same residence from the date of known HIV diagnosis to the date of the survey (63 percent versus 51 percent; p = 0.024). CONCLUSION Although no definitive causal association can be provided by this cross-sectional analysis, our results clearly highlight several ways in which the need for treatment and care potentially affect where persons with HIV/AIDS choose to live.