The majority of children living with HIV in the United States are apparently receiving routine medical care, known as being retained in care, but there is certainly room for improvement.
The Centers for Disease Control and Prevention (CDC) conducted an analysis of 2010 to 2014 medical claims databases, searching for data about children with HIV under the age of 13 in order to determine whether they were retained in care, defined as attending medical visits every three to four months as recommended. They published their findings in the Morbidity and Mortality Weekly Report.
The CDC estimates that 2,477 children younger than 13 are living with diagnosed HIV in the United States. Examining the MarketScan Multi-Site Medicaid and MarketScan Commercial Claims and Encounters databases, the researchers for this new study came up with a cohort of 163 HIV-positive children covered by Medicaid and 129 children with HIV covered by commercial insurance.
The Medicaid cohort was 65 percent African American and was evenly divided between males and females. In this cohort, the age bracket of 6 to 10 years included a higher proportion of children, 37 percent, compared with the other four age brackets (age 1 and younger; 2 to 5; 6 to 10; and 11 to 12). In the cohort that received commercial insurance there was an even balance between males and females as well as between the different age brackets.
The investigators analyzed data on the children over a 36-month period. During the first two years, 60 percent of the Medicaid cohort and 69 percent of the commercial-insurance cohort were retained in care. From those two groups initially retained in care, a respective 93 percent and 85 percent remained in care during the last 12 months of the 36-month period.
The national goal for children’s retention in care is 90 percent.
Children who qualified for Medicaid because they were blind or disabled were 2.45 times more likely to be retained in care than other Medicaid recipients. Additionally, foster children on Medicaid were 3.4-fold times more likely to be retained in care than the rest of the Medicaid cohort. Among those receiving commercial insurance, children 12 months and younger were 62 percent less likely to be retained in care than older children.
To read the report, click here.