Reducing financial barriers to HIV-related medical care: does the Ryan White CARE Act make a difference?

We evaluated whether the Ryan White CARE Act, which funds medical care and supportive services for low-income HIV-infected persons, equalizes health service use in San Francisco. Clients at nine CARE (n = 300) and four non-CARE (n = 172) funded sites completed self-administered questionnaires. There were no significant differences between CARE and non-CARE clients with respect to physician visits, hospitalization or emergency room use in the previous year after adjusting for sociodemographic characteristics and health status. Unemployment and poor health independently predicted higher medical service use. CARE appears to reduce financial barriers to medical services.