In contrast to ED utilization in the general population, sociodemographic characteristics and drug use contributed little to the probability of ED visits in a cohort of HIV-infected persons receiving care in 1991–1992; ED utilization was primarily driven by disease severity [5]. In-patient utilization has declined and out-patient utilization increased with the advent of highly active antiretroviral therapy

(HAART), but rates of ED utilization have not been reported in the current era of HAART [6–10]. ED care is expensive and may be potentially avoidable. Identifying factors associated with ED visits is an important step in improving healthcare delivery to HIV-infected patients and reducing healthcare costs. As HIV-infected patients are now living longer and healthier lives [11–14], GSK-3 inhibitor we hypothesized that ED utilization and in-patient admissions would GW572016 be more strongly associated with sociodemographic and substance use characteristics, compared with factors related to the clinical aspects of HIV disease [15–19]. The objective of this study was to assess

utilization rates, reasons for ED utilization, and patient characteristics associated with ED utilization in the HAART era among patients who have a primary source of HIV care. We evaluated the characteristics associated with one or more ED visits, including demographic factors, frequency of primary care visits, pain, CD4 cell count and HIV-1 RNA. We also examined factors associated with being admitted to the hospital from the ED. This study was

a cross-sectional survey, based on in-person interviews with patients recruited from HIV clinics. Patients were not recruited directly from EDs. The HIV Research Network (HIVRN) is a consortium of out-patient clinics that provide primary and subspecialty care to HIV-infected adult and paediatric patients. Clinics abstract specified data elements from patients’ medical records; abstracted data are assembled into those a uniform database and submitted to a Data Coordinating Center [2,20]. Patients are identified only by a coded ID number in the medical record database. Fourteen out of the 15 clinics that treated adult patients participated in conducting interviews with patients. Six are located in the Eastern USA, three in the Midwest, two in the South and three in the West. Seven clinics have academic affiliations; seven are community-based. Initially, Data Coordinating Center staff drew a random sample from each participating clinic using the coded IDs in the medical record database. The sampling frame consisted of active patients in 2002 at these sites. Sampled IDs were then sent to the clinics to be linked with personal identifiers by clinic staff. Because of confidentiality restrictions, each sampled patient had to be first approached by a clinic staff member to solicit participation in the interview. Clinic staff mailed letters of invitation to potential study patients at their last known address.