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J Health Hum Serv Adm. 2014 Spring;36(4):498-519.

Medical service use among individuals receiving HIV prevention services in Los Angeles County.


Timely provision of medical services among communities at increased risk of HIV infection is crucial to detect the infection and to further prevent the spread of HIV. In the US, about one third of HIV cases were identified in the later stage of infection. The current study utilized the Gelberg-Andersen behavioral model for predicting medical service use among people who were at risk of HIV infection. The candidate variables included: social support, attitudinal, and behavioral variables. The data were collected from clients of HIV prevention agencies in Los Angeles County in 2004 who participated in the Countywide Risk Assessment Survey (CRAS). Using a logistic regression model, the study suggested that factors that were positively associated with use of medical services included living in a treatment center/halfway house or mission/shelter, experience of physical/sexual abuse, and ever receiving HIV testing/counseling. Factors inversely associated with medical service use were male gender, education, and consumption of alcohol. Analysis was conducted using SAS 9.3. Most of the findings are consistent with the Gelberg-Andersen model. The exception was that victims of physical or sexual abuse were more likely to use services instead of less likely as predicted by the model.

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